Monthly Archives: November 2017


Diabetes Madlib #2

Clueless About Diabetes Madlib

[source: diabetesduo.com]

With November being National Diabetes Awareness Month, here is another version of the Diabetes Madlibs.  How many of these misconceptions have you held?  Have you ever thought that all types of diabetes are the same?  It may be time to get to know someone with diabetes, they can teach you a lot.

(Answers provided by Ronei, but they are not representative of her knowledge and support of people with diabetes, this is for comic value only.)

“Oh, you have Diahbeedees? So your stomach doesn’t work, right? Well, at least you don’t have emphysema. My Grandmother has it and got it because she ate too much fruit. Last year, she had her toe cut off! I hear you can cure it by drinking water? I feel joyful for you because those fuzzy needles would make me pant. And I could never have someone burp one of those pump things in my knee. My cousin had juvenile diabetes but outgrew it when she turned 54. I was reading in the Enquirer that Helen Mirren had it but reversed it by eating only sushi. And Jimmy Fallon has it and he’s lived a long time with no problems. I also read where lots of people who have it bad travel to Ireland because they have a cure for it there. Don’t get excited, Dr. Who said there will be a cure here in America in 9 years. Then you can start eating kale again!” 

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Taste Buds – Episode 108

An image for your taste buds. A plate of bread and cheese with sliced salmon, a cup of yogurt with berries, a container of fancy crackers, a mug of black coffee, and a plate with red and black grapes, circular orange slices, and a half of grapefruit. It's all laid out on brown parchment paper on a table of raw wood planks.

Review

Smell plays a big part in your ability to taste.  The bumps on your tongue that you can see are actually papillae.

4 Types of Papillae

Filiform

Filiform papillae are the most numerous papillae and are arranged in regular rows running parallel to the median sulcus.  They are cone-shaped – either a single cone (like a volcano shape) or a frill of cones.  These papillae don’t actually taste flavors but they do sense touch.  They work as cleaners, helping your tongue create friction with other parts of your mouth to loosen bits of food from the nooks and crannies.

Foliate

These papillae are located on the sides of the tongue near the back.  They are flat, leaf-like folds, and can be visible in some people.  These papillae contain taste buds for flavors.

Fungiform

These are mushroom-shaped.  They are scattered all over the tongue but seem to be more concentrated on the edges and tip of the tongue.  They contain taste buds for flavor as well as the sense of touch.

Vallate (Circumvallate)

These papillae are dome-shaped with a border.  The best description is that they appear as a circular fort with a mote around it and then a wall on the outside.  Or maybe they look like a bunch of “outie” belly buttons!  They are laid out on the back of the in a V-shaped pattern, pointing towards the back of the throat.  These papillae can be visible in some people, and they contain taste buds for flavors as well.

Each papilla contains many taste buds.  They are called “buds” because, microscopically, they appear as unopened rosebuds. Taste buds have a swirl-like funnel with an opening in the middle that contains fluid.

How You Taste

You put food in your mouth. Your saliva dissolves bits of it to free up molecules.  The molecules that are mixed in your saliva wash into the funnels of each taste bud.  There, the molecules mix into the taste bud fluid and get swirled around to come in contact with as many taste sensors (nerves) as possible.  From here, the chemical signal changes into an electrical signal as the taste messages zoom into your brain.  In the brain, the signal is translated and identified – including details such as flavor, pain, temperature, texture, intensity, and smell (while your saliva mixes with some molecules, other molecules are released into the air as aromatics and contact the olfactory sensors in your nose).

Taste Buds Map Truth

The taste bud map that has been used for years in textbooks was created in 1901.  Even with all the things that we’ve learned about how taste buds work, where they’re located, and what they look like, this map has never been re-written.  The original map identified four basic flavor categories: sweet, sour, salt, bitter.  Yet, just nine years later, the Japanese were able to identify “umami” – that savory flavor that doesn’t quite fit into the other four.  Yet, the map still wasn’t re-written.  Even now, scientists are learning and updating the database on what the tongue can taste and how – including categories like “fatty” and “metal” and even “water”.

So, while the taste buds are not grouped into sections based on the flavor they can taste, some taste buds may have a greater affinity or sensitivity to a certain type of flavor.

It is estimated that we have about 2000-4000 tastebuds, and since the surface of the tongue is like your skin, the tastebuds recycle about every week or two.  This rapid and continuous recycling might be why it is acclaimed that your taste (preference and enjoyment from your taste buds) changes approximately every seven years.

Conclusion

Even though the tastebud categories are still too complicated to rewrite the map, I still plan to use my taste buds to their fullest potential.  Eat up!

Resources

I gathered some of my information from a PubMed article that is actively being updated by real scientists – How Does Our Sense of Taste Work?

Callback

Smell

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Music Credits: Up In My Jam (All Of A Sudden) by – Kubbi https://soundcloud.com/kubbiCreative Commons — Attribution-ShareAlike 3.0 Unported— CC BY-SA 3.0 http://creativecommons.org/licenses/b…Music provided by Audio Library https://youtu.be/tDexBj46oNI


Burning Mouth & Pepto Lips – Episode 107

An image of black lips, partially open to show some of the top and bottom teeth. Maybe the person has a burning mouth, or just had too much Pepto!

 

Burning Mouth Syndrome

Burning Mouth Syndrome is defined as a burning sensation with no underlying cause.  It may include dry mouth sensations with no true symptoms of dry mouth.  BMS is accompanied by unremitting burning or pain but no mucosal changes or signs of injury or swelling.

3 Categories

  • Increases throughout the day after waking
  • Stays the same morning, during the day, and at night
  • Has no pattern

Common Symptoms

  • Bilateral pain of the tongue
  • Chronic pain labeled as moderate to severe, or a 6-10 on the pain scale.
  • Worsened by talking, stress, fatigue, or hot, spicy, or acidic foods.

Subjective Descriptions

  • Dry mouth
  • Change in ability to taste
  • Accompanied by a headache
  • Decreased appetite
  • Improved by cold foods or drinks

Those who suffer from BMS may see temporary relief with topical analgesics (i.e. lidocaine or benzocaine) but see no improvement from systemic medications.  Fifty percent of the cases have no apparent cause but do have some correlation with depression.  This is a case of “the chicken or the egg”.  Are people with depression more likely to have symptoms of BMS?  Or are people with BMS more likely to become depressed?

Before someone can be said to have Burning Mouth Syndrome, many other issues must be ruled out.

  • Deficiencies (iron, folate, B vitamins, zinc)
  • Dry mouth
  • Nerve damage
  • Hypothyroidism
  • Type 2 Diabetes
  • Nocturnal habits (clenching, grinding, tongue-thrusting)
  • Infection (thrush, herpes, HIV)
  • A hiatal hernia (GERD)
  • Medications (ACE inhibitors, anticholinergics)
  • Myeloma (a blood cancer involving plasma cells)

Pepto Lips

Pepto-Bismol, aka Bismuth subsalicylate, has been used for decades for a variety of stomach complaints.

Bismuth is a good binder of toxins, in a similar way that carbon is in activated charcoal.  And yes, bismuth is one of those elements on the periodic table.  Subsacylate activates into salicylic acid (related to aspirin) and works to decrease inflammation of the gastric lining.

When bismuth binds with sulfur that is naturally in your saliva, it becomes bismuth sulfide, which has a black color and can stain your tongues and lips temporarily.  Pepto overuse is the obvious cause of black lips.

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Tongue Issues – Episode 106

Born With…

Ankyloglossia is also known as a tongue tie.  It is a result of a short frenulum.  This issue is easily corrected if it interferes with eating and talking.

Macroglossia is am abnormally large tongue.  This is one of the visible characteristics of Down’s Syndrome.  It is described as the tongue looks and feels to be bigger than space in the mouth.

Infected With…

Strawberry tongue

The tongue can appear extremely red and papillae are swollen to look like seeds on a strawberry.  This is a symptom of several conditions.

  • Kawasaki Disease is a rare but serious childhood disease.  The blood vessels become inflamed, and this includes the blood vessels in the tongue, making it appear red.
  • Scarlet Fever is caused by the same bacteria as strep throat.  The infection goes from being just in the throat to the bacteria toxins spreading in the bloodstream.
  • Toxic Shock Syndrome is when the bacteria called Staph aureus (yes, this is the staph that lives on your skin and can cause wound infections) gets into the bloodstream.  This is a medical emergency and needs to be treated immediately.

Hairy Tongue

White hairy tongue appears as patches on the sides of the tongue.  It can happen when someone who is immunocompromised gets the Epstein-Barr Virus. (Epstein-Barr is a virus that causes mild childhood illness or a disease we know as Mono when teens and adults.)

Black hairy tongue is a little more obscure with several possible root causes.

  • Smoking, excessive coffee or tea consumption, excessive alcohol consumption, or soft diet can lead to the inability to shed dead skin cells.
  • Antibiotic overuse leads to overgrowth of fungus or bacteria.
  • Overuse of peroxide-based mouthwash causes oxidation and discoloration of the skin cells.

Function Lost

Motor Neuron Disease occurs in the later stages of ALS or Lou Gerig’s Disease when the nerves and muscles of the tongue for speech and swallowing become affected.

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Your Tongue – Episode 105

Tongue Basics

Your tongue is made up of eight muscles.  This is why it is called a muscular organ.  It is the most important articulator in speech production. (A brief word dissection:  articulate means to communicate something clearly.  In medicine, articulate means to make a connection.  It all makes sense!)

The tip is called the apex.  The crease down the middle is called the median lingual sulcus.  There is another crease at the back of your tongue and it is called the sulcus terminalis.

Tongue Muscles

The tongue has two types of muscles.  Extrinsic muscles attach to bones boarding the mouth.  Intrinsic muscles are completely contained inside the tongue borders.

Extrinsic Muscles

These muscles are responsible for moving your tongue front to back and side to side.  There are four of them and they are named for the facial bones that they are anchored to.

  • The genioglossus muscle moves it forward so you can stick it out of your mouth.
  • The Hyoglossus muscle pulls it back and presses it down.
  • The Styloglossus muscle raises the sides of it during swallowing.
  • The Palatoglossus muscle raises the back of it during swallowing.  It also presses the soft palate down and squeezes the palatoglossal arch inward during that same step of swallowing.

Intrinsic Muscles

These muscles are responsible for all the shapes and movements your tongue makes when you talk and eat.

  • The superior longitudinal muscle covers the top side.
  • The inferior longitudinal muscle covers the bottom side.
  • The vertical muscle fibers are in the middle and connect the superior to the inferior muscles.
  • The transverse muscle fibers start at the median sulcus and connect to the outer edges.

The Tongue Has Skin?!

The surface of your tongue is known as the masticatory mucosa, which basically means it’s the surface that food comes in contact with.  The surface is made up of epithelial cells just like your skin.  The cells are keratinized (or filled with a toughening protein) so it is tough and does not get damaged by the wide variety of things we eat.

Call Backs

Wrinkly Brain

Skin 101

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Music Credits: Up In My Jam (All Of A Sudden) by – Kubbi https://soundcloud.com/kubbiCreative Commons — Attribution-ShareAlike 3.0 Unported— CC BY-SA 3.0 http://creativecommons.org/licenses/b…Music provided by Audio Library https://youtu.be/tDexBj46oNI