Sharknado 2: Electric Boogaloo: Discovery Channel’s Behind-the-Scenes Docudrama

Tsk tsk, Discovery Channel.

With the recent airing of its Megalodon “documentary,” one of our few remaining “educational” (SCARE QUOTES!) television stations has temporarily, if not indefinitely, blown its credibility. The public outcry against such a deception should ensure that the higher-ups at DC will think twice before once again producing programming which presents false information as scientific fact, while providing only the tiniest of disclaimers to the contrary in its closing credit scroll. Viewers were tricked. Ratings were high. Is this a Bad Thing?

Before I jump into my reasoning for why it’s not, here’s a little more background for those who either don’t have cable, don’t like sharks, or don’t enjoy controversy. Every year around this part of the summer, the Discovery Channel (home to Mythbusters, Dirty Jobs, and…Amish Mafia?) devotes an entire week of scheduled programming to the glory that is the shark. Don’t ask me why, but this has become one of the most beloved traditions of cable television viewers over the past few years. Shark Week consists of a mishmash of documentaries, true life encounters, and other reality-type shows that revolve around (figuratively) dissecting this member of the elasmobranch subclass. These programs are generally touted as informational or educational or AT LEAST nonfictional; like the History Channel or Science Channel, Discovery has generally maintained an air of academic legitimacy in comparison to most other cable television wastelands (but Amish Mafia??). However, a recent and accelerating trend appears to be that these once revered outposts of EDUTAINMENT have been nosediving toward a bullseye with Honey Boo Boo’s face painted in the center. And it’s this decline in informational integrity that is at the core of this latest fish story. During Shark Week 2013, DC aired a documentary detailing the continued existence of the Megalodon, a 60-foot long prehistoric beast with 7-inch long teeth that mysteriously went extinct long ago. This documentary presented evidence from experts (read: not scientists) who built a case around the idea that Megalodon survives to this day, but it turns out that REAL experts (read: scientists) have come out since the airing of this show and refuted pretty much all claims that DC’s talking heads made; that is, there is no real scientific evidence that Megalodon swims with the fishes (or DOESN’T swim with the fishes? Maybe this is the wrong phrase to use here).

So, you can see where the outrage has come from: you’d be angry too after being punk’d by a cable channel. What’s worse perhaps is that polls were taken after the airing of “Megalodon” and a large majority of its viewers now believe that it may still exist.

When I first heard about this hubbub, I was torn as to how I felt about it. Given, I did not see it upon its initial airing, so maybe my opinion is disqualified. However, the more I think about, the more I like the way things turned out. I like it because once the news came out that the documentary was bunk, it reminded people (or SHOULD have reminded people) that the number one goal of television is not to educate. Sure, TV shows can be educational, and oftentimes channels like Discovery or History or Science do produce such programming. However, this aspect of television is a by-product of television’s real aim: to entertain. TV executives need you to be entertained enough by their programming that you don’t think to change the channel and thus continue to boost their ratings. Entertaining the viewer is a means to an end, and we all are aware of this. This goes for all television stations, whether they claim to be educational or not.

This is the reason I like the way things turned out with DC’s shark debacle. It reminds us what television is, and what it is not. What it is: a method of passively absorbing information that requires no real work on the part of the viewer, and as such it is one of the simplest ways to, as a viewer/consumer, obtain information (factual or not). What it is not: a reliable source of facts, scientific or otherwise, and in fact, it is a medium that actually favors the bending of facts towards the fantastical in order to entice interest and continued viewing. If you break it down, television provides ease, but not accuracy. It seems that the more dry or boring the reference material is, the more likely it is reliable as fact; while this is by no means always true, it seems to be a decent enough measuring stick by which to judge a piece of information’s authenticity. If you have to work for the knowledge you seek, not only are you more likely to be rewarded with truth, but you’ll also feel a greater sense of fulfillment in your work paying off. Holy crow, is this a self-help blog now?

Keep in mind, too, that even the most academically researched documentaries usually have an agenda. If you can decipher that agenda during viewing, it may help you to parse what’s scientifically true or un. Just because television shows are developed as a passive medium doesn’t mean that you can’t actively engage with them.

Unfortunately, assuming a Pandora’s box point-of-view, DC may be headed further away from infotainment and more towards sensationalist pseudoscience. In other words, watch carefully. The next documentary you see may star Tara Reid and Ian Ziering.

Doctor, Doctor, Give Me the News; I’ve Got a Bad Case of Listening to You

Dear Dr. Google,

First of all I want to apologize for sending such an impersonal correspondence. Usually I’m the type that enjoys writing a physical letter, putting the pen to paper and practicing the skills I learned in First Grade; however, it seems that the only way to reach you is electronically. I guess in this day and age, what do I expect?

I suppose it’s apropos, since all of our interaction up to this point has been through those underground pipes known as the Internet. Speaking of our interaction, the reason I’m typing to you today is because I want to discuss our relationship. As in any such discussion, there are positives and negatives I want to cover, so I guess think of this correspondence as a kind of Interpersonal Duracell.

Let’s start with the good stuff. Since I first found out about your near-limitless expertise, you’ve been the first entity to which I turn when things go pear-shaped. In a sense you’ve been my safety-net, my blanky. When I had chest pains, you diagnosed me with Primary Spontaneous Pneumothorax (PSP). When I got dizzy upon standing, you confirmed my case of Orthostatic Hypotension. In short, you’ve always had answers. You’ve always saved me a trip to the local urgent care.

You’re ALWAYS there. A wealth of information, a plethora of ideas. It was from you that I learned about Polycystic Ovary Syndrome (PCOS) – granted, I don’t own ovaries, but it’s good to know what it would be like if they were to go Krang on me. Likewise, you schooled me on Systemic Lupus Erythematosus (SLE) and how any site-specific pain I’m feeling at any given time just might be lupus. You’ve taught me so many acronyms! Oh, and don’t even get me started on fibromyalgia.

So now that I’ve covered the chocolate crunchy portion of the Dairy Queen ice cream cake, let’s get to the disappointing vanilla section. Ya see, endless information, especially health-related information, is an infinitely sharp and autoincisive double-edged sword. I won’t mention the time you made me think I had a metastatic colon polyp when it turned out to just be gas. Nor will I rub in your face your misdiagnosis of a sinus headache as an aggressive and strangely springtime-linked brain tumor. Not to mention the nagging stress caused by these missteps that was run through your medical processors and doctoral prestidigitation and spit back at me in a differential list that included ventricular arrhythmia, chronic asthma, and Sudden Infant Death Syndrome (SIDS).

I’ve come to realize that having all the world’s medical knowledge at my fingertips is a wonderful and dangerous thing, like a lawn dart. In the hand of an untrained professional (I do eyes; the other 99% of the human body is only a soft fleshy carrier for the eyes), unfiltered information is a one-way train to Worryville. And I’m the mayor of Worryville (I may have rigged the election).

The point, Dr. Google, is this: I’m switching my care to a different provider. I don’t want a doctor who is going to scare the flapjacks out of me with the possibility of muscular dystrophy or Marfan’s or gouty arthritis. While I will forever appreciate your penchant for being totally transparent, I need a caregiver who obfuscates the ugly truth. I need someone who sugarcoats things. I need Dr. Feelgood.

So, until the next time I have shoulder pain or cough up blood, we’re through.

No longer yours,

Apertis Oculis

Tips for Healthy Eyes in 2013

Well, we’re not all dead, so it looks like we’ll have to endure another year.  2012 gave us many things to remember, although I can’t really remember any of them right now.  With that in mind, let’s look forward to 2013 and the best ways to keep your eyes healthy in the year to come.

1.  Vitamins A, C, and E (the antioxidants) are good for your eyes.  Vitamin Q, however, is not.  NEVER take vitamin Q.

2.  Despite popular knowledge, wearing someone else’s glasses will not cause your vision to deteriorate.  Although wearing them might turn you into that person.

3.  Avoid staring into the sun.  This can cause damage to the eye known as solar maculopathy.  That being said, this damage generally only occurs after prolonged viewing of the sun; if you just want to glance at it, that’s fine.  The sun is pretty.

4.  Flashes of light or an increase in floaters in your vision may signal a retinal detachment, which requires prompt detection and treatment.  These symptoms may also be caused by attending a rave; if you hear a thumping bass beat, you probably don’t have a retinal detachment.

5.  Double vision, or diplopia, is a bad thing.  If ever you should see double, get yourself to an eye doctor immediately.  You may have an aneurysm.  You may also have a drink in your hand; if you have a drink in your hand, the diplopia is probably not as urgent, although you should get to an eye doctor soon anyway, just in case.  Put the drink down first though.

6.  Call your mother; she wants to hear from you.  This has nothing to do with eyes, but it’s just good advice in general.

7.  When your optometrist offers to dilate your pupils, go along with it.  Yes, your near vision will be blown to smithereens for a couple hours.  Yes, the sun will seem so bright that it’s as if the star around which our little planet revolves has a personal vendetta against you.  Yes, your eyes will look as though you just indulged in an illicit mind-altering substance.  However, with dilation, your optometrist can detect not only ocular abnormalities, but many, many other systemic diseases that may have as yet gone undiagnosed by your primary care physician.

Even Mario hates being dilated.

Even Mario hates being dilated.

8.  If your eyes burn, they’re probably dry – use artificial tears.  If your eyes water, they’re probably dry – use artificial tears.  If your eyes feel “tired,” they’re probably dry – use artificial tears.  If artificial tears, they’re probably artificial tears, use artificial tears.

9.  Take your contact lenses out of your eyes.  Unless you’re not wearing contact lenses.  Overwearing your contact lenses can lead to the following:  vision-threatening eye infections, corneal neovascularization, giant papillary conjunctivitis, corneal edema, and jelly bumps.  Yes, jelly bumps.  You may ask, “What are jelly bumps?”  Wear your contacts for too long, and you’ll find out.

10.  If you’re staring at a computer screen right now, take a break!  Every 20 minutes look away from the screen for 20 seconds.  Computer vision syndrome exists and is becoming an epidemic; you can avoid it entirely by just looking away. Go ahead, look away.  You’re not looking away.

Look away.

Do it.

You’re not going to miss anything.

I promise.

Really, at this point I’m just trying to be facetious.

Have you looked away yet?

So those are 10 tips for protecting your eyes for the new year.  2013 looks like it’s shaping up to be a good one, and I think we owe it to ourselves to make it count since we survived 12/21/12.  Be happy, be safe, and I’ll see you at the party after we all survive 13/21/13.

The League of Extraordinary Newscasters

*****The following excerpt has been taken from an email released by Anderson Cooper’s public relations administrator.  It is being reposted here in the hope that the background behind this story reaches the general public and garners Mr. Cooper more recognition for his efforts above and beyond those required of his chosen profession as a television show host.*****

Ladies and gentlemen of the press:

First and foremost I’d like to dispel the rumor that has been circulating since the story of Mr. Cooper’s temporary blindness originally hit the wires:  the rumor that Mr. Cooper experienced any sort of heightening of his remaining senses as a consequence of his loss of vision is completely unfounded and purely based on speculation.

As most of you know, Mr. Cooper was stricken by a painful and alarming condition called “photokeratitis,” or so I’m told by our staff optometrist.  This condition is apparently caused by prolonged exposure to ultraviolet light, either direct or reflected, which essentially degrades the surface layer of the anterior surface of the eye, or cornea.  While this condition is temporary, it usually causes moderate to severe discomfort as well as blurry vision.

That being said, and although I am happy to say that Mr. Cooper has made a full recovery, we here at the CNN camp find it reprehensible, given the recent events involving the disappearance of Mr. Cooper’s on-air correspondent, Ms. Isha Sesay, that the rumor of Mr. Cooper’s so-called “superhuman abilities” has gained such a foothold in the popular media.

And before I continue with just how ridiculous these claims are, I’d like to also put to rest the following allegations regarding Mr. Cooper’s behavior of late:

  • He has not destroyed every pair of sunglasses he owns.
  • He has not been staring at the sun’s reflection in the water of Long Island Sound.
  • He has not been practicing judo while blindfolded.

I have come to understand that the above allegations have gained popularity due to the temptation of portraying Mr. Cooper as a real-world superhero; i.e. the belief that he obtained a heightened sense of hearing, smell, and touch as a result of his loss of vision.  While I cannot account for the lack of an alibi regarding Mr. Cooper’s whereabouts upon the onset of this photokeratitis, I want to assure the press that he was NOT, as the parlance goes, “fighting crime.”

Furthermore, the above allegations have been made with the thought that Mr. Cooper is attempting to regain his super-abilities through submitting himself to a second episode of photokeratitis with the intention of using these powers to locate the missing Ms. Sesay and bring her captors to justice.  While I cannot 100% deny this claim, I invite the press to consider just how outrageous it sounds.

Now, I can sympathize with the temptation to portray Mr. Cooper as a so-called “superhero,” given his strong jawline, silver-fox hair color, and desire to bring wrongdoers to task (“keeping them honest,” so to speak).  I can honestly say that in the times in which we live, such a person is absolutely warranted.  Mr. Cooper is just not that person, despite my own personal experience in his presence post-blindness in which I witnessed him identifying one Mr. Matt Lauer, who was having a casual conversation with an acquaintance on the sidewalk outside of the Anderson Cooper 360 studio while Mr. Cooper himself was actually inside said studio.  This is not an indication of super-hearing, but merely a coincidence.

Nevertheless, Mr. Cooper, since his recovery, has carried on with the taping of his television news program, and refuses to acknowledge any of the above allegations.  I know what you more hopeful member of the press will say:  He is only denying these claims in order to protect his identity as a crimefighter.  To you folks, I have no rational refutation.

In summary, and putting it bluntly, Anderson Cooper does not have superpowers, is not a superhero.  Please stop perpetuating these rumors.  Because even if he is, and you truly want him to be, his efforts will only be harmed by your continued coverage.  Just let him be the superhero that he is.  Or is not.

Thank you for reading.  And please pray for the return of our beloved Ms. Sesay.  We hope that Mr. Cooper can bring her to safety.

wikipediacooper

Re:

In answer to my last post regarding writing letters, I have prepared the following as a response to the sample patient letter I composed.  Fellow optometrists, I encourage you to have a stack of these handy so that you’re prepared when a patient hands you the previously typed letter.  I do accept monetary donations.

Dear [patient name],

I appreciate your forethought in preparing the letter you have given me, which outlines your concerns about your eyes.  It takes a person with a large amount of [intelligence, kindness, good looks] to come up with such a well-worded document.  Anyway, let’s talk about your eyes.

You may take this as an indication of your age, but I recommend a [bifocal, trifocal, prosthetic eye].  I know this kind of thing is not good for your vanity, but I’m an optometrist, not Tim Gunn.  We have many different choices in spectacle frames, however, and I’m sure you can find something that makes you look [distinguished, flirty, other adjective]; that is, until your glasses inevitably get [lost, broken, eaten by the dog or vice versa].  In which case it’s probably a good idea to go ahead and buy a second pair as well.  Hey, seeing well and looking good ain’t cheap.

All health-related aspects regarding your eyes look good, although your ocular surface looks a little dry; I recommend [Restasis, artificial tears, looking up when it rains].  Your eyes don’t feel dry, you say?  They actually water all the time and are the exact opposite of dry?  Well, believe it or not, it’s possible that your eyes water because they are dry – this is a common occurence in people with dry eye syndrome; basically the tears your eyes are producing are [not of good quality, not coating your eye properly, crocodile tears].

I did not see any signs of serious ocular diseases such as glaucoma or macular degeneration, although you do you have very early cataracts forming.  Not to worry, as these are generally very slowly progressive and at worst will only cause you to have trouble with [reading, glare, thinking your spouse is attractive (kind of like nature’s beer goggles)].  When the time is right and you feel like your vision is no longer acceptable to the point that you can no longer perform everyday tasks, then we can talk about referring you to the local ophthalmologist’s [office, clinic, van] for cataract extraction.

Oh, I can see as you’re reading this that you have to hold the paper pretty far out from your face; either you are presbyopic or the paper just smells really bad.  If it’s the former, the bifocals I prescribed earlier will help; if it’s the latter, it’s probably because our paper is made from [recycled products, card stock, Soylent Green] kind of like those old Weekly Readers from grade school.  Remember those?  God did those things reek.

In summary, you should be good to go until your next annual eye exam, and I do mean annual, rather than the decade-long gap since the last time you were here.  Speaking of which, you should probably dispose of the trial pair of contact lenses that we gave you at that last visit; they’re probably a little [protein-deposited, worn out, nah nevermind they’re fine].  Call me if you need anything, otherwise I’ll SEE you then!  Haha, eye doctor humor!

Sincerely,

[Doctor’s name]

Aaaaaaaand scene!

To all of you optometrists out there who read this, see if you can get me an honorary Fellowship in the Academy for this great service I have provided you; writing case reports is so overdone.  And besides, what good does yet another case report do?  Either it reinforces previously known treatment protocol or it presents such a rare variation that no one will ever see such a thing again.  (What you’ve just witnessed is me justifying the fact that I’m writing on a blog rather than writing case reports.)

Like any doctor-patient relationship, communication is key.  And nothing communicates how much you care about your patient like a letter typed by a stranger on the internet.  So until next time, keep it real.

Trail of Tears

Are all artificial tears created equal?

This is a question that I imagine many people must ask themselves when they walk down the eyecare aisle at Wal-Mart, or Target, or Jewell-Osco, or Costco (I actually don’t know if Costco has an eyecare aisle, but if they do I like to picture 10-gallon drums of Opti-Free).  I admit, until recently, I couldn’t recall the last time I had ventured down the eyecare aisle; as an eye doctor, I benefit from freebies at work.  But now that I’ve taken the time to wander down that aisle flanked by multicolored boxes of artificial tears and contact lens solutions, I can understand why people feel a little overwhelmed.  It’s a veritable Rainbow of Uncertainty.

It’s a similar experience to those times when the wife tells me to buy her some shampoo; all the bottles look the same to me, so I pick the cheapest one.  Honey, I’m sorry you ended up looking like James Carville.

Did that say “Pantene” or “Paint Thinner?”

So when your eyes are feeling dry and you just want a little relief, how do you pick which artificial tears to use if they all look the same and promise the same things?  Maybe you heard Ben Stein say on TV that Clear Eyes will help.  Or maybe you have a co-worker who swears by Systane.  Or perhaps you read an article online about a woman who poisoned her boyfriend with Visine.  Stay away from Visine.

Luckily for you, you have me.  I’ll admit, I don’t have a strong opinion on a lot of things, but boy-howdy do I have one when it comes to artificial tears.  Stop laughing at me.

First and foremost, I’m a big proponent of looking at ingredients.  Whether I’m buying artificial tears or artficial sweetner, I want to know what’s going in my body.  With eyedrops, the active ingredient you’re mostly likely going to see is the lubricant itself, such as glycerin, polyethylene glycol,  or carboxymethylcellulose.  You may also see a preservative, such as polyquaternium or benzalkonium chloride, listed.  Preservatives can be sort of a mixed bag; they’re good in that they keep bacteria from contaminating the bottle, but they may also be responsible for causing ocular toxicity if used too much, thus defeating the whole purpose of an artificial tear in the first place.  For this reason, I generally prefer a preservative-free drop, such as Theratears, for those times when frequent dosing is necessary.

Exciting stuff, right?

YES THAT IS EXCITING

Another thing to consider, after ingredients, is the specific application of different types of artificial tear.  Some claim to be better for certain types of dry eye, some are better for night time, some give you X-ray vision.  You don’t want to buy the wrong drop at the wrong time.  That is, if you were to pick up some Genteal ocular ointment and put that stuff in while you’re at work, have fun looking at life like it’s a dream sequence for the next 15 minutes – you might as well smear vaseline on your face.  So be careful about the indications on certain products; if there’s a moon and stars on the box, it’s probably not indicated for high noon.

“Okay almighty optometrist,” I can hear you saying to your monitor, “so which artificial tears do you recommend, specifically?”

Well, for your everyday run-of-the-mill mild dryness, I use a lot of Systane Ultra and OptiveSystane Gel and Blink Gel are both good if you like a thicker drop.  For dosing more than four times a day, I use Theratears.  If overnight lubrication is needed, an ointment like Genteal is great.  I try to stay away from Clear Eyes and Visine if possible (and it’s usually possible).

Now you know, and knowing is half the battle.  “What’s the other half of the battle?” you ask?  I…I’m not really sure.  G.I. Joe only ever gave me 50% of the formula for winning the battle.  Let’s say the other half involves artificial tears.  Aaaaaaand we have closure.

The End.

Lasers: Welcome to the Future (It’s like the present only more futurey)

Lasers.

The word conjures in my mind an image of space cowboys on the backs of rocket-hoofed horses dueling on the moon.  Their pistols blaze with a green glow as their foes fall to the crater-laden ground, although they fall more slowly due to the decreased gravity.  Beams of light fly through the air as the interstellar battleground becomes littered with injured space cowboys.

Unfortunately, the reality of lasers is slightly less awesome, although I guess that depends on your perspective.  The reason I bring this up is because I’m always being asked about laser eye surgery, the most common of which is LASIK.  LASIK is short for laser-assisted in-situ keratomileusis, which is a fancy way of saying that the cornea is burned with a laser.  Just imagine one of those space cowboys shooting you in the eye until you can see better.

Not what I was thinking, but I would trust Clint Eastwood with my eyes any day.

In actuality, lasers have been commonplace in medicine for quite some time now, and LASIK has come a loooong way since its inception.

To start with the basics, LASIK involves cutting a flap in the cornea (if you don’t know what the cornea is, see previous post The Eyes Have It).  This flap is lifted, but remains attached to the rest of the cornea on a hinge.  The layer of the cornea under the flap is then ablated with a laser, which flattens it and causes a decrease in your glasses prescription.  Said flap is then laid back down over the ablated tissue and smoothed out so your vision doesn’t resemble the view through a crinkled piece of Saran wrap.

There is an alternative (and chronologically older) form of laser surgery called PRK, or photorefractive keratectomy.  In this case, no flap is involved.  The uppermost layer of the cornea is actually removed using an alcohol solution, revealing the underlying layer (the same underlying layer that was laser-ablated in the above LASIK example).  The laser is applied to this layer, once again to flatten the cornea and decrease your prescription, and then the superior layer is allowed to grow back.  After the lasering, the surgeon will place a bandage contact lens (basically a normal contact lens with no or little prescription built into it) on your eye to guide the smooth regrowth of the top corneal layer.

So what’s the difference?  Is there a difference?  Which is better for you?  Why did Lost wait until its last season to introduce that glowing cave?

I can’t see what’s in there, but it looks like a plot device.

One of the major differences between LASIK and PRK involves the healing time and the discomfort associated with the healing.  LASIK wins hands-down here, and many patients get to appreciate the WOW factor of having greatly improved vision the day after surgery.  PRK wins the tortoise award in this regard, since it can take up to approximately a week before improved vision can be appreciated; similarly, PRK patients experience more discomfort during this elongated healing time.

Another difference is in the potential complications post-surgically.  Common negative experiences post-LASIK include moderate to severe dry eye syndrome and halos around lights.  The halos generally are due to the fact that the flap does not heal completely (although this is somewhat a point of contention) and instead a ring-shaped faint scar is formed, thus when the pupil dilates in low light conditions the scar may actually fall within visually significant range.  In the case of PRK, one of the more painful potential side-effects are called recurrent corneal erosions, in which the inside of the eyelid essentially sticks to the superior layer of the cornea during sleep, and upon awakening a small chunk of corneal tissue is pulled off by the eyelid, leaving a small but painful wound.  Just like humans, no procedure is perfect.

In the case of both procedures, you’ll be using copious amounts of eye drops afterward:  artificial tears, antibiotics, anti-inflammatories, et cetera.  There will be a few post-operative visits involved as well, which can be co-managed by your optometrist after an ophthalmologist has performed the surgery (more excuses for us to see each other!).

Anyway, that’s a short course on laser surgery.  While it may not be as cool as space cowboys, it’s still pretty neat.  And if you’re not impressed, you can always do it yourself.  (CLICK LINK AT YOUR OWN RISK.  My blog does not represent medical advice, and if you take it as such, I cannot be held responsible and will probably shake my head at you.)