Major League Baseball Bans Under the Tongue Deer Antler Spray Use

On Aug 6, 2011, ESPN reported that MLB players have been issued a warning regarding use of Deer Antler spray administered under the tongue.

Deer-Antler spray contains "potentially contaminated nutritional supplements" along with IGF-1 (Insulin Growth Factor) which players have used in the past as an alternative to steroids, especially given it can't be detected in urine samples (only blood testing).

What's with Deer-Antler spray specifically? Scientists discovered IGF-1 in the velvet of immature deer antlers and IGF-1 is considered a performance-enhancer that mediates the level of human growth hormone in the body.

Why under the tongue (sublingual administration)? Because the mucus membrane is quite thin under the tongue richly underlaid with capillary blood vessels allowing for direct diffusion of the substance directly into the body's bloodstream with little or no alteration. This process takes less than a minute to occur. This is in contrast to swallowing a pill which gets digested in the stomach with acid, further digested in the intestines with enzymes, absorbed into the hepatic circulation where further degradation occurs in the liver before getting into general body circulation for effect. A 30-60 minute process.

That's why sublingual nitrogen is such a potent medication to treat chest pain due to an impending heart attack. It works FAST!

It's another reason why sublingual immunotherapy otherwise known as allergy drops is a growing acceptable alternative to allergy shots to try and cure allergies.

Read the ESPN story here.

According to Researchers 35.09 Is Age When Beauty Starts to Fade

My colleague, Dr. Houtan Chaboki, shared the link to an article in Wmagazine first published in Feb 2011 regarding how Japanese researchers determined 35.09 years is the exact tipping point when beauty starts to fade.

35.09 years is exactly 33 days after the 35th birthday.

Hmmmm... I'm not sure about the science here, especially given the researchers work for skincare company SK-II. And proffer their $250 Skin Signature Melting Rich Cream as a solution.

What do the masses think if corporate scientist lackeys are to be disbelieved? Well, QVC did a survey of over 2,000 men and women and found that age 31 is the tipping point. Doubters of this age may point out that this survey also is biased as QVC is not exactly an ivory tower institution.

Read the Wmagazine article here.

Read about the QVC survey here.

What About a "Voice-Lift" with your Facelift?

I was informed about this interesting concept on ABC news...

With many aging baby boomers tapping into cosmetic surgery in order to look younger, some are taking it a step further to "sound" younger as well with a "voice lift".

For some, it's not right to look 10-20 years younger after a facelift but still sound like 70 years old.

A hoarse voice with aging is not unusual, but a surgical "voice-lift" is not necessarily the first step that should be taken.

First things first...

• Make sure the hoarseness is not due to something bad like vocal cord cancer. As a person ages, risk of cancer does increase especially if tobacco and alcohol use is present.

• Make sure there are no physical problems with the vocal cords like paralysis, polyp, cysts, reflux, etc.

Beyond that, vocal limitations often seen with the aging voice should first be addressed with voice therapy. Bowed vocal cords as well as compensatory muscle tension dysphonia are conditions often seen in this patient population causing a significant raspy voice and often respond quite well to voice therapy. Should voice therapy fail to resolve the vocal disquality, than surgical options can be considered.

What are the surgical options?

Just like a facial wrinkle may require a collagen injection to plump it up or a chin implant to address a receding chin, the vocal cord can also undergo collagen injections or receive an implant to plump it up and give it volume lost to aging which can lead to vocal problems.

Click here to read more about this procedure.

Click here to read the ABC new report.

"Ear Picking" - A Barber Shop Service Health Hazard?

It was only recently that I heard of "ear picking," a barber shop service that is apparently quite common in Asia and recently becoming more popular in the United States in cities with large Asian populations.

In essence, ear picking is when a variety of implements - scrapes, picks, and lights - is used within the ear canal.  Why is it popular among Asians? Mainly because of the type of earwax that is produced by Asians which is mainly dry and flaky which causes an itchy sensation. Ear picking helps remove some of this cornflake-like earwax as well as get the itch "scratched" and is apparently quite a pleasurable experience... like getting an itch on your back scratched. Caucasians have more peanut butter or wet type of earwax which is not amenable to "picking".

This unlicensed service is most often performed in barber shops and unfortunately has led to a number of ear related infections (eardrum perforations, fungal ear infections, bacterial ear infections, etc) as the tools are not sterilized in between customers.

If you want a "professional" type ear cleaning, see your local ENT. Itchy ears can be treated without resorting to ear canal instrumentation along with its risks of infection and eardrum perforations!

Read more about this phenomenon here.

Novel Treatment for Glue Ear?

Glue ear is the layman's term for thick mucoid effusion of the middle ear, usually due to chronic ear infections.

The fluid itself is like maple syrup and usually treated with ear tube placement followed by suctioning as much of the fluid out as possible. However, given there is always some residual present, antibiotic ear drops with steroids is often prescribed.

Unfortunately, these patients are at higher risk of requiring repeated sets of tubes after the body spits them out.

Why?

Because of a phenomenon called biofilms... Think of it as teflon armour made of slime for infections. You can put antibiotics and steroids on it, but they kind of just slip off. Such biofilms make infections nearly 1000 times LESS susceptible to medications. In order to truly eradicate the biofilm (and underlying "hidden" infection), you either have to "scrape" it off which is not possible in the middle ear or use very high concentrations of antibiotics... much greater than that obtained using oral or IV antibiotics.

Though ear drops containing high concentrations of antibiotics are possible, the drops tend to come out of the ear just as easily as they go in preventing prolonged and enduring contact.

That's were the recent innovation comes in...

Scientists in England have developed a biodegradable antibiotic "pellet" that can be inserted into the middle ear during surgery where it will slowly release high concentrations of antibiotics to target any infections present (active or inactive) over 3 weeks continuously. Furthermore, the pellet contains N-acetylcysteine which effectively breaks apart the biofilm.

In essence, this pellet is like an armour-piercing bullet.

Of course, it is not available in the US yet... nor is it FDA approved.

Read more about this here.