A variety of everyday health concerns . . . from the Fair!

Last Sunday I joined 197,890 of my closest friends at the Minnesota State Fair.  Along with the best radio person in the business, Denny Long, I did a live, in-person broadcast of Healthy Matters.  This was our 451th (!) live broadcast and my 9th year doing it from the state fair. I’m serious about the 197,000 figure.  That is literally the number of people who attended – on just this one day – the country’s second-largest state fair (Texas is bigger but also runs twice as long).

To all of you who came out to see the show in person, thank you!  It was great to meet people from all over the region . . . Moose Lake, Lonsdale, St. Louis Park, Woodbury . . . . but for those who didn’t make it last week, you have another chance!  Come out to the Minnesota State Fair on Sunday, Sept 3, at 7:30 a.m. and say hi!  We’ll do the show live from the veranda at the WCCO radio booth.  If you come up and introduce yourself, I’ll put you on the radio and you can ask a health question.  The WCCO radio booth is easy to find on Carnes Ave between Nelson and Underwood.  It’s right by the Ye Olde Mill and right next to a Sweet Martha’s cookies.

As always, you can listen to podcasts of all previous shows by going to the WCCO website.

Sunday morning at the fair has become one of my favorite times.  It’s not yet too crowded, everything is open, and the weather is usually cool and comfortable.  Horses are out walking the grounds.  The air is crisp.  Most of all, I get to chat with listeners before, during, and after the radio broadcast.  And you know what? People are incredibly warm and kind.  Sometimes during our tumultuous public discourse we forget that we are all pretty much decent people deep down.  And I get to see that each week at the fair.

You know what else?  Most of us have some minor, or not so minor, health issue.  Just about everybody who talks to me has some health or wellness issue to talk about.  Oddly, I find some reassurance in that as well.  Perhaps our common and inevitable brushes with health issues brings us together a bit.  And so, here are some of the issues I talked about with regular folks at the fair . . . maybe you can identify with some of them!

My purpose here isn’t to give you in-depth information about any of them but rather to get a sense of the smorgasbord of health and wellness.   Here’s what your neighbors asked me last Sunday . . .

Topic 1:  Men and their prostates

One guy at the fair was wondering about his prostate and the numbers he gets from the doctor’s lab.  The PSA lab tests keep coming back just a bit elevated and he wonders what to do.  I told him that mildly elevated PSA results are most likely not cancer, but you can’t be sure, so he should probably simply repeat the test every 6 months or so.  More likely, he has benign prostatic hyperplasia, or BPH.  Benign = non-cancerous.  Prostatic = from the prostate (a gland which men have).  Hyperplasia = “too much growth” or “enlarged.”  For more on BPH, click on this reliable site from the NIH.

And it is pros-tate, not pros-trate.  There’s only one “r” in there.   Subtle but important difference!

Topic 2:  What’s the deal with shingles?

Not one, not two, but three people at the fair asked me about shingles.  This one is common!  Nearly 1 in 3 people will get herpes zoster from the varicella zoster virus (VZV) which is the exact same virus that causes chicken pox.  Don’t worry, VZV is a member of the herpes family of viruses but it not the same virus as the one that causes genital infections.  (That one is herpes simplex virus).

After you get chicken pox, the virus never really leaves your body.  Instead, it sets up shop in your nervous system, only to reactivate at a later time, usually a much later time, like when you get older.  When it reactivates, it occurs only in a dermatome of your body, which is an area of skin served by a particular nerve.   Here’s a dermatome map (the bane of medical students everywhere who are forced to memorize it):

So when it reactivates, it looks like chicken pox in one dermatome, like this poor guy:

So the question everyone wants to know is . . . should I get the shingles vaccine?

In response, I tell people that the shingles vaccine, unlike some other vaccines (like measles or pneumonia) is perhaps a bit less critical.  However, given that 1/3 of us will get shingles, and of those 1/3, some will go on to a lifetime of neurologic pain even after the rash goes away (a condition called post-herpetic neuralgia), I think it is wise to get the shingles vaccine.  So if you are over 60, that’s you!  Here’s more on shingles and the vaccine from the CDC which is another reliable site.

Topic 3:  Weird rash

Another man I met at the fair has had a weird, itchy rash on his back.  He has been putting on a low-dose steroid – think hydrocortisone – but the rash is persistent.  It’s only on his back and it’s really itchy.  What could this be?

This is where I wish I could do a quick physical exam, you know, actually look at his back.  Skin problems are by their nature very visual – you have to see them to diagnose them.  But we thought better of having this guy take his shirt off right next to the Giant Slide!

So we talked in generalities about skin problems.  There’s a saying in medicine that for rashes, 1) if it’s wet, make it dry and 2) if it’s dry, make it wet.  Dermatology in a nutshell. I’m certain every single dermatologist objects to that saying but I find it rather funny!  It means if a rash is wet then make it dry with an anti-fungal.  Like for athlete’s foot.  But if it is dry and itchy, put an anti-inflammatory on it – a steroid cream.  Like for dermatitis.

There are a variety of itchy rashes that fall into these categories, but there are many that don’t.   Here’s just a few of the common rashes.  There are lots and lots more.

• Dermatitis / eczema.  Something comes in contact with the skin that irritates it, or it is allergic, or due to some other cause.  Usually needs an anti-inflammatory like the hydrocortisone you can buy at the store, or the stronger ones prescribed by your doctor.
• Urticaria / hives.  This is usually an allergic problem.  Anti-histamines and anti-inflammatories are called for.  See an allergist.
• Psoriasis.  A silvery plaque-like rash.  This is a systemic disease.  See a dermatologist and a rheumatologist.
• Drug reaction.  A generalized (not local in one place on the body) could be due to a medication you are taking.
• Tinea.  A skin fungal infection.  Tinea pedis = athlete’s foot.  Tinea corporis = fungal body infection.  Tinea cruris = jock itch.  Tinea capitis = head fungus.  All treated with topical anti-fungals.

Just a sampling of rashes, brought to you from the Minnesota State Fair.  Lots more info on rashes, including good pictures, can be found from DermNet New Zealand, which to me is a good site.  Those kiwis know their rashes.

Topic 4:  Mini donuts vs. scones vs. cookies.  A raging debate.

OK, this is not a medical topic but it is a burning hot topic.  Within a few footsteps of the WCCO radio booth at the Minnesota State Fair are three options to satisfy your Sunday morning need for yummy treats.

• Chocolate chip cookies in overflowing buckets of gooey goodness.  (Sweet Martha’s)
• Scones like you’ve never seen before.  (French Meadow)
• Mini donuts in the classic bag to devour hot.  (Tom Thumb).

Which is your favorite?

Here’s the deal.  You come out to the fair this Sunday (September 3, 2017), grab your favorite treat, and come greet me at WCCO.  Good plan.  Show airs LIVE from 7:30 – 8:30 Sunday morning.

See you at the Great Minnesota Get Together!

-David

Twitter @DrDavidHilden