The Grief and Mourning Quiz

Medical Author:

Benjamin Wedro, MD, FACEP, FAAEM

Benjamin Wedro, MD, FACEP, FAAEM

Dr. Ben Wedro practices emergency medicine at Gundersen Clinic, a regional trauma center in La Crosse, Wisconsin. His background includes undergraduate and medical studies at the University of Alberta, a Family Practice internship at Queen's University in Kingston, Ontario and residency training in Emergency Medicine at the University of Oklahoma Health Sciences Center.

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Medical Editor:

Melissa Conrad Stöppler, MD

Melissa Conrad Stöppler, MD

Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

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Debunking Summer Health Myths

Medical Author: Melissa Stoppler, M.D.
Medical Editor: William C. Shiel, Jr, MD, FACP, FACR

As children, most of us heard lots of health advice. Unfortunately, some of it, however well-intentioned, was medically incorrect. See if you've ever heard - or believed - any of these common summer health myths.

1. "Wait a half hour after eating before you can safely go swimming." This one seemed almost universally accepted when I was a child and is still believed today. The myth involves the possibility of suffering severe muscle cramping and drowning from swimming on a full stomach. While it's true that the digestive process does divert the circulation of the blood toward the gut and to a certain extent, away from the muscles, the fact is that an episode of drowning caused by swimming on a full stomach has never been documented. Neither the American Academy of Pediatricsnor the American Red Cross makes any specific recommendations about waiting any amount of time after eating before taking a swim. There's a theoretical possibility that one could develop a cramp while swimming with a full stomach, but a person swimming in a pool or controlled swimming area could easily exit the water if this happens. As with any exercise after eating, swimming right after a big meal might be uncomfortable, but it won't cause you to drown.

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What is drowning?

According to the World Health Organization, "Drowning is the process of experiencing respiratory impairment from submersion/immersion in liquid." The possible outcomes of drowning are classified as death, morbidity (the development of disability or injury), and no morbidity.

This relatively simple definition was agreed upon at the 2002 World Congress of Drowning held in Amsterdam. Prior to that meeting, some definitions and classifications of drowning were not necessarily well defined, and their meanings were subject to a variety of interpretations by different countries and health organizations. While some people still try to sort drowning events into categories (for example wet vs. dry, primary vs. secondary, fatal vs. non-fatal), these terms may or may not adequately describe a patient's situation, the effects of drowning on their body, or the potential outcome.

Drowning is a common cause of death and disability. In 2002 over 400,000 (worldwide) people died from drowning; of the 400,000 deaths, 129,000 were in China. In the US it is the third most common cause of accidental death, with 3,500 deaths per year, or 10 per day. Twenty-five percent of the victims are children aged 14 and younger.

The death rate from drowning does not reflect the potential morbidity (disability) due to brain injury for those who survive a drowning episode.

What happens during drowning?

Drowning occurs when water comes into contact with the larynx (voice box).

• After an initial gasp, there is an initial voluntary breath holding.
  
  
• This is followed by spasm of the larynx and the development of hypoxemia (hypo=low + ox=oxygen + emia=blood), or decreased levels of oxygen in the bloodstream.
  
  
• Lack of oxygen causes aerobic metabolism to stop, and the body becomes acidotic. If not corrected quickly, the lack of oxygen in combination with too much acid may lead to problems with the electrical conduction system of the heart (cardiac arrest) and lack of blood supply to the brain.
  
  
• As body function declines, the larynx may relax and allow water to enter the lungs. However, up to 20% of drowning victims have persistent spasm of the larynx, and no water is aspirated (this was formerly known as "dry" drowning).