3 Diseases You *Really* Don't Want to Catch

It was a little hard to unwrap a gift from my wife without taking it personally. After all, it was a book called "The Hypochondriac's Pocket Guide to Horrible Diseases." Am I really this neurotic? (This is your cue to vote or opine. You won't get another opportunity like this anytime soon.)

But I'm not easily offended, so I took a look—pure 24K hilarious gold. In retrospect, this is not surprising because the author, Dennis DiClaudio, writes for Comedy Central and the Onion. One of his other works is "The Deviant's Pocket Guide to the Outlandish Sexual Desires Barely Contained in Your Subconscious." You get it. Dennis is clearly twisted. That is not to say that I wouldn't want to have lunch with the guy; I'd probably just want him to take a 23andMe test first, just to check for an even number of chromosomes. 

I thought it might be interesting to see what happens when the world's funniest organic chemist (n = 1) gives a science lesson based on a very funny book about "medicine." 

Disease #1 - Trimethylaminuria

If you're in need of a Scrabble word with 17 letters and six vowels (sadly, no O), this bad boy is for you; otherwise, you may wish to avoid it. Trimethylaminuria, an excess of the chemical trimethylamine, results from a genetic disorder that leaves unfortunate individuals without an enzyme called flavin monooxygenase 3 (aka trimethylamine monooxygenase). This wouldn't be all that bad except for the fact that trimethylamine is one stinky chemical. How stinky? Think dead fish. This is not so surprising because rotting fish produce...trimethylamine. 

This makes life for flavin monooxygenase 3-deficient individuals and their inner circles quite unpleasant. In the absence of an enzyme to metabolize (1) the stuff, it accumulates in the body, excreted in the breath, urine, and sweat. Unless one of your life goals is to walk around smelling like dead fish, this affliction is best avoided.

Here's the biochemical process that fails to occur in the absence of flavin monooxygenase 3:

In the absence of the enzyme trimethylamine monooxygenase, trimethylamine (left, stinky) conversion to trimethylamine-N-oxide (odorless) is blocked. (1)

This does little to enhance one's popularity. DiClaudio writes:

"For some reason that has not yet been identified, people with particularly bad cases of trimethylaminuria have a hard time maintaining romantic relationships."

D. DiClaudio

Perhaps this is why the wretched dating site Plenty of Rotting Fish was worse than most of the rest of them. Maybe.

Disease #2 - Norwegian Scabies

If it's any small comfort, the Sarcoptes scabiei mite, which causes just plain old hideous "normal" scabies, is the same parasite that causes the exponentially more hideous Norwegian scabies. It's not clear why the normal disease involves a few dozen mites embedded in your body, while the Norwegian variety can involve millions of them – a thought that must provide little comfort to those afflicted. 

DiClaudio advises:

"Prepare yourself for a lot of itching and some seriously allergic rashes. Your skin will grow calloused and thick, somewhat deformed by your body's hyperkeratotic response against these insects, where your nails will become misshapen and gnarled. Scales of dead skin will fall from your body like snow, making anything you touch infectious to others. Fortunately (or unfortunately), you won't die."

What to do? Bring on the chemicals! But first, you have to scrape off the scales (always entertaining in case of a lull in the conversation at dinner parties) so that the insecticides can penetrate the skin to get to the little monsters. Since it takes, unsurprisingly, insecticides to kill insects, this causes quite a problem for faux environmental groups like the Natural Resources Defense Council (NRDC), which hates both chemicals and pesticides. In fact, malathion, a commonly-used agricultural pesticide that is used to treat scabies, prompted the non-scientists at the NRDC to claim "Two pesticides, chlorpyrifos, and malathion, 'jeopardized the continued existence' of more than 1,200 endangered plants and animals."

But, pay no attention to the poly-sci majors and lawyers behind the curtain. The very wealthy but scientifically clueless NRDC equated the pesticide chlorpyrifos with Sarin, a deadly nerve gas developed by the Nazis, a fake scare that was so wrong that I decided to chew them a new organic a####e. 

Disease #3 - Cyclic Vomiting Syndrome

It doesn't take a lively imagination to envision what this doozy of an affliction involves. Cyclic vomiting syndrome (CVS) is just about as bad as it gets. 

"Episodes of excessive vomiting may last for hours or days and will usually weaken your body to the point where nearly any activity – besides puking – is impossible. Eventually, though, it will just go away, and you'll be perfectly functional for several weeks or months. Until the next time."

The Mayo Clinic calls the syndrome "idiopathic," which, as DiClaudio explains, means "nobody knows why you're sick, you just are." Fortunately, some drugs can be useful in controlling CVS. Antiemetic drugs, including Zofran (ondansetron), which was designed to control nausea and vomiting from chemotherapy, are effective, as are acid blockers like Pepcid. Interestingly, a class of migraine drugs called triptans have been shown to reduce or even eliminate episodes of CVS. These drugs act by binding to two different serotonin receptors, suggesting that CVS is a disorder of the central nervous system disease, not the stomach. 

"Diagnosis of cyclic vomiting syndrome is difficult since it is often confused with other gastrointestinal problems such as pledging a fraternity"

These three maladies only scratch the surface (there's a joke in there) of DiClaudio's book. As horrendous as these three are, there's stuff in there that's worse. Finally, the book makes a great bathroom read, especially since there's a chapter on Chronic Idiopathic Diarrhea.

Stay well. 

NOTE:

(1) There is another metabolic pathway for eliminating trimethylamine called oxidative dealkylation, but it does not perform well enough to get you a girlfriend.