APRIL 4, 2012

Thwarted again


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dr daveI feinted left but he was too quick and caught me with a crisp jab. As my head snapped back I glimpsed an opening and landed a twisting uppercut to his chin. He reeled and I followed with a sweeping right hook to the temple that buckled his knees. He back-peddled to a corner, so I moved in. Countering, he connected with a devastating combination jab/hook that momentarily stunned me. I fell back. But seven years of college hockey (I had a long college career) had trained me well. I answered with a stiff jab to his flaring nostrils but he answered right back with a kick to my midsection. So I reached for a bottle of liquid nitrogen, grabbed his flailing foot and worked him hard. A minute later it was all over. “Thanks doctor, I hope little Mikey wasn’t too tough on you. Should we come back next week for another liquid nitrogen treatment of his wart?"

While kids might hate warts they despise wart treatment and positively loathe wart treaters. To those who feel that the above struggle is not entirely plausible, I should advise you that my PG 13 rating prevents me from including the really vicious portions of the battle involving teeth, scalpels and Tonya Harding.

All this fuss over a virus no bigger than a mosquito’s zit. Warts are caused by HPV, known as Human Papilloma Virus or more commonly the Horrific Pimple Virus. It enters through a breach in the skin and may take months or even years to incubate. Different types of warts are caused by different varieties of the 70 strains of HPV, including:

Plantars Wart: Warts on the feet are a common adolescent concern. Plantars warts begin on the weight-bearing portions of the foot and are so named because as they enlarge, walking feels as though a Planters peanut is imbedded in to the foot. Warts are “caught” from public showers or swapping low fives with warty friends. What may start as a single wart may multiply into several warts, which may in turn fuse into large plaques that can consume the entire soul of the foot. To treat; pare down the wart until it begins to bleed, then freeze with liquid nitrogen (use the spray only, not a cotton swab), thaw, freeze again, then cross fingers.

Subungual Warts: Found under and adjacent to the fingernails, these warts are notoriously persistent and painful to treat. Some success is found with 5 percent imiquimod, a rather expensive cream that is applied after soaking and filing down the wart.

Common warts: 10 percent of the general population has warts. Fifty percent will disappear spontaneously within two years. These warts should be soaked in warm water, pared or pumiced, soaked again, treated with a chemical weapon (acids, cantharidin, podofilm) and then occluded with tape or plastic for several days. If all fails, liquid nitrogen MIGHT work.
Flat warts: Small flat warts are usually found on the top of the hand or on the face. They are easily spread on shaved areas such as the legs of women and beards of men (or vice versa).

Genital warts: Extremely common amongst sexually active teens, debate continues as to whether condoms protect or not. Though not exactly the same HPV that causes cervical cancer, the presence of genital warts is a red flag for potential cervical cancer. Tough and painful to treat (physically and emotionally).

So friends, parents, countrymen, send us your ears, your downtrodden and your donations. But hesitate before sending us kids with warts. The pain they incur from our “treatments” induces a fear reflex between patient and doctor. Years later when they need to see a doctor for something less painful like a ruptured liver or javelin accident, all they can think of is the pain associated with wart treatment from the guy in the white coat and brass knuckles. “Doc, go ahead and wiggle that javelin in there all you like, just don’t use your liquid nitrogen.”

And now, as my day comes to a close, my nurse informs me, “Doctor, four year old Suzy Stallone is here with a plantars, and she looks like she could go five rounds or more.”

Thwarted again.

Learn more and meet Dr. Dave or contact him at www.wisequacks.org.