Food Poisoning

By Minh Nguyen, Candidate for Doctorate of Osteopathy 2016 and Courtney Mizuhara-Cheng, D.O.

It was Friday night.  You’d had a long week. There was a new restaurant you had been wanting to try. Why not? You deserved it. Everything was spectacular; until you got home and started to feel ill. You threw up, everything you just had and paid for. Nature called you to the toilet multiple times. It was good that you had the weekend to recover. 

Most likely, you got food poisoning, which according to the CDC, 48 million cases happen each year. Fortunately, it is mostly self-limited and preventable. This article hopes to provide you with the information regarding causes, treatments, and what you can do to prevent it from happening.

CONNECT WITH FOOD POISONING

What is food poisoning?

Food poisoning is an illness that occurs when you consume food that is contaminated with bacteria, viruses, and parasites. Norovirus is the most common causes. Other common causes include the bacteria Salmonella and E.Coli. A list of food-borne pathogens can be found here. 

What are the symptoms?

The symptoms vary in severity and onset, but they most commonly include nausea, vomiting, abdominal pain, watery or bloody diarrhea, and fever. 

However, some bacteria can cause atypical symptoms.

Botulism can cause descending paralysis.

Hepatitis A or Listeria can cause meningitis and spontaneous abortion.

HARMONIZE WITH YOUR STOMACH

How does food get contaminated?

There are different ways that your food can get contaminated:

Food-handlers who are sick do not wash their hands when preparing the dishes.

The germs in the food grow because food was cleaned, washed, or cooked enough.

Cross-contamination between different food groups during preparation: for example, using the same knife to cut meat and vegetables without washing in between. 

What are the treatments for food poisoning?

Most often times, food poisoning goes away on its own; therefore, treatment is supportive. 

Both vomiting and diarrhea can lead to serious dehydration. It is very important that you drink plenty of water to keep yourself well hydrated. It is also beneficial to replenish your electrolytes, which can be found in sports drinks, fresh squeezed fruit juices, pure coconut water, or Emergen-C.

You can eat small low-fat meals to provide your body energy to heal, as well as allowing the digestive tract to rest and digest. 

If you feel tired or fatigue, be sure to give yourself plenty of rest. Catch up on reading that book, or just simply sleep. 

Antibiotics are not always recommended. However, a 5-day course of ciprofloxacin or Bactrim is commonly used for traveler’s diarrhea or dysentery. 

INTEGRATE YOUR HEALTHY OPTIONS

When to see the doctor?

While food poisoning is self-limited, in some cases, it can persist or worsen. Visit your primary care physician if you experience any of these symptoms:

Severe abdominal pain

Unable to eat or drink

Blood in your vomit or stool

Fever of 100.4 F or more

Certain age groups are more susceptible to food poisoning, such as the elderly and children. Should they experience the above symptoms, it is important that they receive medical care as soon as possible. 

What are some ways to prevent food poisoning?

Often times, contamination occurs during food handling. Therefore, hand washing is crucial and the reason why all restaurants demand that their employees wash their hands after using the bathroom. If you have a young child, wash your hands after changing the diaper. If you have allergies, wash your hand after you blow your nose. 

Wash your hands anytime you handle any “germy” objects. 

When you are sick with food poisoning, stay home and rest. Not only will you recuperate, but you will also decrease the chance of contaminating someone else. 

Food safety can also greatly help in prevention, such as:

Do not leave food out for more than 2 hours (1 hour if the temperature is above 90F)

Do not consumed unpasteurized milk or dairy products

Wash fruits and vegetables before consuming them

Cook meat and seafood until well done

Use different knives for different food groups, or if using the same knife, wash it between uses

A more comprehensive list of tips for food safety can be found here. 

If you would like to learn more details about food poisoning, you can find it here. 

Self-Injury

By Dr. Courtney Mizuhara-Cheng, D.O., and Minh Nguyen, Candidate for Doctorate of Osteopathy 2016

Many people have different ways of coping under stress.  In this scenerio, a student doctor describes an interaction she witnessed with slight alterations to protect the identity of the individuals involved.  

“Would you mind taking your sweater off so I can look at your arm?”  My young patient accompanied by her mother presented with right arm pain. I had noticed an interesting dynamic between the mother-daughter duo.  “She’s a whiner. Been complaining about that stupid arm for months. I want you to tell her today that it’s normal and she’s being a baby, and so I can get on with my day,” said the mother.  As I had learned in medical school, I always started with the normal side, her non-hurting arm, to compare. There they were; lines: old and new and scabby and pink and perfectly parallel to each other, lines that had been created with the help of a razor blade. I was taken aback, but then it dawned on me that I should have suspected something. It was a scorching hot day in Southern California, and my 13 year-old was wearing a sweater.  “What are those? WHAT DID YOU DO? They weren’t there two days ago! WHAT DID YOU DO?” cried the mother with tears streamig down her face. In the midst of shock and confusion, the mother left the room, slamming the door behind her.  Silence filled the room, as my patient looked at her hands.

What is Self-Injury?

Self-injury is any deliberate, non-suicidal behavior that inflicts physical injury your own body. Contrary to the common stigma, self-injury is a coping mechanism that may enable a person to deal with intense emotional distress, creating a calming sensation. Self-injury may be used to "awaken" a person from the numbness or dissociation related to the hidden emotional pain. It is not a cry for attention and it is far from uncommon. Those that practice this coping mechanism tend to do it in private and hide their injuries from the public, such as wearing baggy clothes, sweaters, etc. While self-injury may bring a brief moment of calm and release, it is not a cure. It is usually followed by guilt and shame and the return of the emotions people try to run from in the first place.

Who Self-Injures?

Self-injury affects peopple from all walks of life, irrespective of age, gender, sexual orientation, ethnicity or personal strength.

What are some ways of self-harm?

Some forms of self-injury get talked about more often than others, but you may have found your own unique ways to hurt yourself. It is still self-injury.

• Cutting
• Burning
• Breaking bones
• Head banging
• Biting
• Pulling out hair
• Persistently picking at wound and interfering with healing

If you or someone you know has self-harming behaviors, a health care professional can help to provide alternative coping strategies and address the underlying emotional stressor.  By understanding the cause of the coping mechanism, the hope is that one can make positive changes in their lives, empowering themselves to move away from self-injury to healthier coping mechanisms.  

CONNECT WITH YOUR BODY

What causes a person to self-harm?
According to HelpGuide.org, here are some myths and facts about self-injury:

HARMONIZE WITH YOUR FEELINGS

What can I do to help?

Express your feeling by journaling or other artistic expressions (i.e., art, poetry, etc).  All yourself to be honest and avoid negative judgements about yourself to enter.
Treat your body and your mind. Put yourself and your well-being first. 
Regular physical activities release a great amount of endorphins, which can boost your mood and reduce stress.
Healthy meals with fresh fruits and vegetables can help.
A good night sleep will have a great positive effect on your day.
Spend time everyday doing something that you enjoy.

INTEGRATE YOUR PHYSICIAN

How is Self-Injury treated?  

Treatment for self-injurious behavior can be difficult as self-injury is often kept secret and hospital treatment frequently avoided.  Talking about self-injury can be really hard. Treatment relies on understanding the underlying emotional stressor.  Problem solving skills-training and cognitive behavior therapy is available within counseling and talking therapy.  If you are considering psychotherapy, different coping strategies to deal with emotional stress must be in place prior to therapy starting to avoid a potential increase in frequency and severity of self-injury.

Where do I find help? 

If you are doing self-injury, the first and most important thing you need to know is: it is okay to ask for help. Asking for help is not a weakness, and it is far from a shame. It is the first step of the most empowering journey you will ever take. To know and accept yourself, to want and embrace change is courageous and heroic. 

That said, reaching out can feel extremely difficult, if you are worried that people will judge you. Know that everyone needs support at one time or another, even the strongest and most successful. 
When you are ready, choose someone that you trust: a friend, a family member, a mentor, a counselor, a psychologist, or your doctor, etc. There are support groups, online or in person. You do not have to walk this journey alone. 

Where can I find more resources? 

www.helpguide.org, www.selfinjury.com, www.reachout.com
Remember, you are not alone.