Gout?

Dear Nurse Dave,
What is gout? and do I have it?
Paul, Fairbanks AK

Gout is an arthritis like disease that occurs when uric acid builds up in your blood. Your kidneys generally are supposed to get rid of this acid but sometimes they aren't up for the job. It can be quite painful.

As you can see if you have gout usually one of your toes swells up to a grotesque size, your pajamas become ill fitting and you begin to question the meaning of life. But rather than just curse life you can seek for ways to treat it. You can go with a natural treatment guide like these two guys did which can include diet changes, herbal supplements and wearing tight fitting t-shirts (note: although the wavy line surrounding the two men appears to be a line indicating stink, stink is not a common symptom of gout).

Or you can go the medical route with anti-inflammatory drugs and allopurinol to reduce uric acid. Good luck Paul.

Jerk

Dear Nurse Dave,
Is it ever okay to be a jerk? Are there situations where being a jerk is not only called for but important?
Ed, Sims, AL

I was actually recently pondering this due to a situation where a local grocery store tried to charge me more for hotdogs than I should have been charged. When the clerk would not believe that I'd been overcharged I switched into jerk mode. I think this befuddled the man and he ended up giving some of the hotdogs to me for free. I felt a satisfaction but also a guilt. Should I have been mean to this poorly educated man and should I really have been buying 5 packages of hot dogs?

I think there are situations where being a jerk can be an advantage to you. Cutting in line. Complaining at a restaurant thereby getting a free meal or at least a free desert. Badgering the poor uneducated guy at the grocery store regarding hotdogs. Moving in on the girl that your roommate was interested in. Ignoring the phone call from someone that is going to want you to do something. These are all areas where being a jerk can be an advantage but I'd argue that none of them are really okay. Is a piece of pie really worth demeaning a waiter? I guess it depends on the pie.

Really I don't think you're going to find a situation where its okay. In the end after you act like a jerk you're just going to wish you'd handled the situation in a more mature manner. I mean the girl was pretty and she wasn't even interested in my roommate but I probably could have talked to him first.

Rollerblading?

Dear Nurse Dave,
I'm thinking about bringing back rollerblading. What are your thoughts?



Grayson 'Set It & Forget It' Weeks
Logan, UT

Honestly Grayson, I'm not sure I'm ready for it. The pure awesomeness that was and is rollerblading may be too much for me. I got my first pair of blades when I was 12 or so and naturally that led to street hockey which naturally led to the kind of gang activity portrayed in the film Rollerboys. I'm not sure I'm ready for that kind of dystopian future. Sure we can of course thank rollerblading for the development of the knuckle puck, a hockey shot so raw and powerful that it only could have been developed on the streets. But we also have to thank rollerblading for the 2002 remake of Rollerball. I'm just not sure we can trust humanity with something as powerful as rollerblades. I think that the government should have outlawed rollerblades much like they outlawed the production of hoverboards. Haven't we learned that some things just need to be kept out of the reach of the common man?

So yes I think it would be awesome for rollerblading to come back but am I ready for it? No, I'm not and I'm not sure the world is either.

Circadian Rhythms

Dear Nurse Dave,
I hear that you are going to start working night shifts. Do you think that staying up all night will drive you slowly insane? If not do you think that could be a good plot for a Nicholas Cage movie?
Theo, New York, NY

Theo the body has a natural rhythm of sleep and wake cycles known as the circadian rhythm. It is commonly accepted that to disrupt this natural rhythm can have negative outcomes. I, of course, fear this disruption but I've got something else even more disturbing to fear. ICU psychosis. That's right I now work in an ICU and it is known to cause psychosis. Yesterday I went outside for a run and realized that was the first time I'd seen the sun in over 3 days. Causes of ICU psychosis include:

-sensory deprivation (I can't really use the internet at work)
-sleep disturbance (night shift is 7pm to 7am)
-continuous light levels (the light is always the same level of dull light that you might associate with the bathroom of a cheap movie theatre)
-stress (in the ICU nurses titrate medication drips that if improperly or poorly managed could kill somebody)
-lack of orientation (not seeing the sun ever).

The psychosis can manifest itself as extreme excitement, anxiety, restlessness, hearing voices, clouding of consciousness, hallucinations, nightmares, paranoia, disorientation,agitation, delusions, abnormal behavior,fluctuating level of consciousness which include aggressive or passive behavior. If that doesn't sound like an awesome Nicholas Cage movie than I don't know what does.

For further information on the disruption of circadian rhythms and the slow growing melancholy that will eventually destroy you, listen to this.

Black or Brown Shoes?

Dear Nurse Dave,
Should I wear the blacks shoes or the brown shoes?
David, Nashville, TN

First listen to this song. Now think about what look you're trying to go for. Black shoes = professional, tight pants, college educated, efficient, shoe shine, yogurt eating, probably shops at the GAP, well groomed hair, interested in the girl with the cool hair, purple tie, listens to hip hop. While brown shoes = might have gone to college but probably got a degree in something useless (English), full head of hair but not well combed, disorganized but still gets the job done, prefers smoothies, well read in subjects that don't matter, closet has at least one hawiian shirt, listens to folk music.

If this is for an interview go with the black shoes. If this is just daily life you've got to go brown.

Fear

Dear Nurse Dave,
What do you think I should fear?
Paul, East Brunswick NJ

There's a lot of things that would could be afraid of or worry about. There's Parkinson's Disease. It can destroy the nervous system and leave you with little ability to act for yourself. The disease can do this quickly or take a long time. There's heart disease. Your coronary arteries can become so clogged that the muscle of your heart is no longer provided with the oxygen it needs. Apparently that hurts and can kill you.

Or maybe you want to fear germs and bacteria. Methicillin-resistant Staphylococcus aureus is powerful staph infection that can't be treated by standard antibiotics. C-diff can infect you GI tract and give you explosive diahrea. These germs and just hanging out anywhere you go Paul.

Or maybe you want to fear politics. Listen to Fox News, Obama is intentionally trying to destroy the country. Watch MSNBC and learn how republicans want to tax only poor people. Look at the international stuff Paul. Greece's financial situation could cause the downfall of all of Europe.

Perhaps you want to fear illegal immigrants, or maybe fear getting a tumor from using your cell phone, maybe you should be afraid of never finding a good job, maybe you should worry about the demise of social security, or carbon monoxide in your home, what about global warming, overfishing the oceans, the demise of bookstores, high fructose corn syrup, roundup ready crops, paying too much for a bad haircut, finding true love, we could go all day Paul.

There's much you could fear so just pick something a move ahead. Good luck Paul.

Trey

Dear Nurse Dave,
I think the kids are getting back into the 80's right now. Are the 90's next? Should I get a bowl cut to be a step ahead of the trends? I'm very interested in being cool.
Trey, Kingwood, TX

I think your name alone gives you a leg up on the rest of us. Look at this list of Treys, everyone a winner. So I think the first thing you got to do to be cool is rely more heavily on your name. Maybe wear a t-shirt that says "my name is trey" or perhaps a belt buckle that simply says trey. Those two things alone buy you a lot of cred.

As for haircuts if you want to go 90's skip the bowl cut and go for the David Silver. Its the right move.

Other cool tips from me would include
1) Become an expert on something somewhat obscure and then talk about it a lot (I do this with science fiction novels but don't steal my subject)
2) It's only okay to admit that you want to be cool if you are already cool and just admitting it out of mock humility (its also good to talk about how you didn't have friends in high school this shows people that high school kids just weren't ready for your particular brand of coolness, this works well for me)
3) Chew gum. Cool guys chew gum. (i go through 1-2 packs a week)
4) Get very interested in the Fast and Furious movies but do it in such a way that people can never tell if you really like the movies or not
5) Lift weights

Finally remember you can never be ahead of the trends. You have to set your own trends.