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Authors: Mark Leyner

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DOES HAVING A LOT OF HEARTBURN MEAN THE BABY HAS A FULL HEAD OF HAIR?

Heartburn or acid reflux is extremely common during pregnancy. During pregnancy, the placenta produces the hormone progesterone which serves to relax the smooth muscles of the uterus. Progesterone also relaxes the smooth muscle in the sphincter between the esophagus and the stomach. This allows stomach acids to sneak up the esophagus, causing heartburn. Progesterone also slows down the wavelike contractions of the stomach, making digestion sluggish. It doesn’t help that you have a large baby inside who is also pushing on your stomach.

Knowing all this, if heartburn caused babies to grow hair, most newborns would look like little chimps. This one is definitely a myth.

DOES EATING FISH MAKE THE BABY SMARTER?

This one gets rather complicated.

Recently there have been many warnings for pregnant women to avoid certain kinds of fish in order to prevent mercury poisoning. Shark, swordfish, king mackerel, and golden or white snapper (tilefish) are to be avoided because they contain high levels of potentially brain-damaging mercury. It is generally recommended that pregnant women have only two servings of fish (ones that are low in mercury) a week, but these warnings may lead women to eat even less.

On the other hand, there is evidence that the fatty acids in fish may also help prenatal brains develop. This is where the problems really start. Eat too much fish and you risk potential problems with mercury poisoning. Eat too little, and you might deprive the developing brain of fatty acids that may make your baby smarter.

Docosahexaenoic acid (DHA), an omega-3 long chain polyunsaturated fatty acid, is the main fatty acid that is found in fish and that is needed for brain development. Some nutritionists recommend that pregnant women get their DHA through algae-derived supplements. Omega-3-fortified eggs are another good source of DHA.

CHAPTER 6

EYES, EARS, MOUTH, AND NOSE

It was
another day at the therapeutic offices of Leyner and Dr. Billy. Leyner was especially happy—he was listening to his new iPod and had just downloaded an obscure but remarkable hip-hop version of Verdi’s
Rigoletto.
Our next clients were a family we’d never encountered before. This was their first session. And it was quite a revelation to see them gathered in the waiting room—father, mother, and five children of varying ages from five to fifteen. The extraordinary thing was how they were dressed. They were each arrayed in matching outfits—shiny orange polyester shirts, with lemon yellow vests, and sky blue slacks. Each wore an individually colored kerchief knotted around his or her neck.

Wendy shepherded the colorfully attired flock into the office.

The mother spoke first, in an angelic voice. “Is he going to listen to his headphones the whole session?”

I elbowed Leyner and he responded far too loudly, “Dude, Nas is singing ‘Questa o Quella.’ Can you wait a minute?”

I shrugged and apologized to the family. “He’s just getting in the mood for the session. So what brings you here today?”

The mother reached inside her bra and withdrew a pitch pipe and blew a clear, dulcet note. She turned to her family and they began to sing a chorale rendition of Kelly Clarkson’s
American Idol
—winning ballad, “A Moment Like This.”

The music was beautiful and ethereal, but occasionally a harsh discordant sound would emerge from among the younger children. The mother silenced them one by one until only a sheepish six-year-old boy was singing, shifting his weight uneasily from foot to foot, his head bowed. He stopped, knowing that he was the culprit responsible for the squeaky sound that ruined an otherwise perfect performance.

The family remained mute, but Leyner ripped off his headphones and added, “Man, what was that horrible sound?!”

The father silenced him with a glare. “This is why we are here!”

I gently quizzed the family to learn more about their difficulties. It turned out that little Richard was a wonderful brother and son. He excelled in all his academic pursuits and was an all-star forward in his peewee soccer league. Unfortunately, he couldn’t carry a tune to save his life, which in this family was an unforgivable sin.

I discovered that since infancy, Richard had experienced terrible trouble with music. The worried family had consulted expert after expert, and even traveled to Vienna to consult the world’s leading specialist in congenital amusia, Dr. Amanda von Binkenstein. As various family members recounted the ignominy of growing up with their hapless atonal sibling, poor little Richard slumped further and further into his chair, his face reddening with embarrassment.

I couldn’t in good conscience allow the humilation of this boy to continue much longer without intervening. I turned to Leyner. “Do me a favor, sing for this nice family.”

Leyner jumped out of his seat. “Really? Can I put on one of those outfits?”

Leyner saw my disapproval, but added anyway, “Can I at least get a pitch pipe?”

He then began to sing one of the most god-awful versions of “Lady Marmalade” that you could ever imagine. The whole family was wincing in pain except for little Richard. The more hopelessly off-key Leyner got, the happier it seemed to make the boy, who couldn’t take his eyes off my shamelessly caterwauling partner.

When Leyner finally finished, little Richard stood and applauded. In a devilish voice, he said, “You’re my hero. You suck even worse than I do.”

The ashamed mother grabbed her son and scolded him. “Richard, apologize to that nice man. Not everyone is a star at everything. We each have our special innate talents.”

I looked into her eyes and she caught herself.

“Hmmm” sang the entire family in unison, nodding their heads in assent with their mother’s therapeutic revelation. They embraced little Richard. Leyner tried to interrupt. “I was just warming up. Can I sing another number?”

The father turned to Leyner and responded, “Don’t quit your day job,” as the family strolled away.

I was left to console a bitterly wounded Leyner, who was left muttering, “What the hell do they know about music!”

ARE SOME PEOPLE REALLY TONE DEAF?

All you have to do is listen to Billy and his wife sing in the car and you will know that the answer is yes.

Tone deafness is the inability to recognize musical tones or reproduce them. It is also called amusia or dysmelodia. This can occur after a traumatic brain injury, but it can also be present from birth. Congenital amusia is the most common term used for tone deafness that is present from birth.

If you want to read about the first reported case of tone deafness, just go to the 1878 journal
Mind
and read Grant-Allen’s article “Note-Deafness.” The article describes the case of a thirty-year-old man who took music lessons as a child, but was completely unable to carry a tune or recognize familiar melodies.

Congenital amusia is similar to a learning disability. Patients do not have any brain injury, hearing loss, or other cognitive deficit.

The other end of the spectrum is perfect pitch or absolute pitch, the ability to recognize a pitch without any external reference. Perfect pitch is thought to involve both genetic and environmental factors.

WHY DO YOU SNEEZE WHEN YOU STARE AT THE SUN?

This is definitely one of those things that you don’t learn in medical school, and we were amazed when we found out that there was a real answer to this question.

Yes, some people do sneeze when they look at the sun. This is due to something called the photic sneeze reflex. It is also known as autosomal dominant compelling helio-ophthalmic outburst or ACHOO, solar sneezing, and photosternutatory reflex. The photic sneeze reflex usually causes more than one sneeze. A study of six Spanish families showed that sneezes occur with a frequency of two to three sneezes per sneezing episode, with about three seconds between each sneeze. The photic sneeze reflex occurs in approximately 10 to 25 percent of the population, but even sun-sneezers don’t do it all the time.

This reflex is not completely understood, but it is thought to occur due to an accidental crossing of nerve signals in the fifth cranial nerve nucleus. This reflex trait is genetic and is passed on in an autosomal dominant manner. That means that if one of your parents is a sun-sneezer, you have a 50 percent chance of being a sun-sneezer too.

If you read the journal
Military Medicine,
you might also know that the photic sneeze reflex is also considered a risk factor to combat pilots.

DOES YOUR HEART STOP WHEN YOU SNEEZE?

When you sneeze, it changes the pressure inside your chest (intrathoracic pressure) and this affects blood flow to the heart. This alteration in blood flow can temporarily affect the beating of the heart, but it most definitely will not stop.

By the way, the medical term for a sneeze is sternutation. Throw that one around and even some doctors won’t know what you are talking about.

WHAT ARE THE LINES GOING DOWN FROM THE NOSE TO THE LIP?

Billy’s mother worked as a genetic counselor at a center for craniofacial disorders. It was a common family event for Mama Goldberg to comment on the philtrum of someone whom she passed on the street. Yes, that vertical groove in the upper lip is called the philtrum. It comes from the Greek word,
philtron,
which means love charm.

The philtrum is formed in embryonic development when the medial nasal prominences fuse, between the sixth and seventh week. The philtrum still needs more refining to achieve its ultimate form, usually by week 14.

Children with fetal alcohol syndrome are often described as having a flat philtrum. Short philtrums and long philtrums are seen in various genetic diseases. If you need more details, just call Billy’s mom, she would love to talk about them.

WHAT CAUSES RINGING IN THE EARS?

Doctors always prefer an esoteric word to describe a simple condition. So they call ringing in the ears
tinnitus.

Tinnitus is very common, with about 36 million sufferers in the United States. There are many different things that cause a ringing in the ears. Some of these are extremely common and most are not very serious, while other causes can be very dangerous. Causes include: age-related hearing loss (presbycusis), trauma, medications (aspirin, antibiotics), changes in ear bones, atherosclerosis, high blood pressure, head and neck tumors, TMJ, Ménière’s disease, ear infection, thyroid disease, increased blood flow, and wax buildup.

Most commonly, tinnitus develops when there is some damage to the hearing apparatus, or the hair cells inside the ears. These are tiny little protrusions that cover the cochlea inside the inner ear. When noises are perceived, these tiny hair cells send electrical signals to the brain that are turned into sound. Some experts think that tinnitus may originate in the brain rather than in the ear.

Famous tinnitus sufferers:

Beethoven

Michelangelo

Charles Darwin

William Shatner

IS EYE COLOR GENETIC?

Did you fall asleep in the back of biology class or what? Don’t you remember Gregor Mendel, the Austrian monk and his pea plants? Mendel was considered to be the Father of Genetics, and if you were listening in high school instead of shooting spitballs, you might remember his round and wrinkled pea pods and the simple laws of inheritance. Unfortunately, these simple laws don’t apply to eye color.

The common assumption that is taught in schools is that brown eye color is always dominant to blue, and that two blue-eyed parents will always produce a blue-eyed child. This is not always true. Two blue-eyed parents can produce children with brown eyes. This happens because eye color is determined by many genes (polygenic) rather than by one.

Eye color is determined by the amount of a pigment called melanin that is in the iris of the eye. Brown eyes have a lot of pigment, and blue eyes have very little. The eye color genes control enzymes that direct the amount of melanin in the iris.

Although eye color is assumed to remain constant over the course of your entire life, this too can change. Eyes can change color as an individual ages or as the result of some diseases. Eye color can also change from trauma, and sometimes there are drug-induced changes that can occur from the treatment of glaucoma.

WHY DO YOUR EYES WATER WHEN YOU POOP?

Okay, well maybe it doesn’t happen to everyone when they poop, but someone who will remain nameless is known to get teary during a good movement. (Okay, it’s Dr. Billy.) For the rest of you, yawning may make your eyes water and the reason is probably the same.

The theory is that during a yawn or a good poo, you scrunch up the muscles of the face. The contraction of these muscles can force the tear ducts and glands to be compressed and that forces out tears.

There are three main types of tears: basal tears (lubricate the eye), reflex tears (think onions), and emotional tears. We suggest a fourth category, poo tears.

WHY DO SOME PEOPLE HAVE TWO DIFFERENT-COLOR EYES?

I (Dr. Billy) have a special attachment to this question. I have had two dear friends who both had two different-color eyes. Ramsey, I am sorry that I am putting you in the same group with Winnie, the Old English sheep dog that we had growing up, but he was special too.

Heterochromia iridium
is the fancy medical name for two different-color eyes in the same person. This is relatively rare in humans, but can be seen frequently in some animals, such as Siamese cats and Australian sheperds. Heterochromia can be the result of an inherited trait, a medical syndrome, or a physical accident. It is thought to result from a change in one of the genes that controls eye color.

A variation on this condition is heterochromia iridis, where different parts of a single eye vary in color. This occurs when one part of the iris has a different amount of pigment (melanin) due to injury, drugs, disease, or a simple birthmark.

Nowadays, all you need is a fancy set of contact lenses and you can have instant heterochromia—just like Marilyn Manson.

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