{"items": [{"author": "Ellen", "source_link": "https://www.facebook.com/jefftk/posts/693101816282?comment_id=693102055802", "anchor": "fb-693102055802", "service": "fb", "text": "https://www.youtube.com/watch?v=pPnrq4QULqY", "timestamp": "1413682242"}, {"author": "Patricia", "source_link": "https://www.facebook.com/jefftk/posts/693101816282?comment_id=693104401102", "anchor": "fb-693104401102", "service": "fb", "text": "Maybe this is the wrong question. How about \"How on earth does this astonishing self-assembling, self-healing machine work almost all the time, extremely well, for many decades, with just a few glitches under more-extreme conditions?\" The body has a lot of responses that need to work well enough most of the time, and which don't work perfectly all the time.
You jam your fingers, well, there are a lot of fluids contained by tissues that need to be flexible and permeable to some degree in order to let you, say, play the fiddle. Some of them wind up leaking. Some of them wind up leaking more than the things that normally carry fluids away can cope with all at once. Even if you don't ice and so on, the body eventually deals with the excess and heals the leaks -- but with our intelligence, we can optimize a bit more, and keep the leaking fluids from overflowing enough to do further damage.
As for fever, we probably reduce them because they're uncomfortable, and we can. The Mayo clinic actually says \"Fevers generally go away within a few days. A number of over-the-counter medications lower a fever, but sometimes it's better left untreated. Fever seems to play a key role in helping your body fight off a number of infections.\"", "timestamp": "1413683997"}, {"author": "Laura", "source_link": "https://www.facebook.com/jefftk/posts/693101816282?comment_id=693105498902", "anchor": "fb-693105498902", "service": "fb", "text": "Long term v short term benifit- even w fever- it helps when that's your only defense against illness, but it's also cooking your brain along with the infection, so you prolly want to treat it. Scars are another example- if you didn't have sterile gauze you'd want your skin to knit together ASAP- with modern med you'd rather it heal slower w less long term impact.", "timestamp": "1413684366"}, {"author": "Bruce", "source_link": "https://www.facebook.com/jefftk/posts/693101816282?comment_id=693105853192", "anchor": "fb-693105853192", "service": "fb", "text": "If you put jam on your fingers Jeff, does the swelling go up or down?", "timestamp": "1413684478"}, {"author": "Adam", "source_link": "https://www.facebook.com/jefftk/posts/693101816282?comment_id=693110159562", "anchor": "fb-693110159562", "service": "fb", "text": "In a sense, the injury not only damages your fingers, but the immune system itself. An oversimplified model involves damaged blood vessels being unable to regulate the release of cytokines, creating a distorted immune signal.", "timestamp": "1413687382"}, {"author": "Daniel", "source_link": "https://www.facebook.com/jefftk/posts/693101816282?comment_id=693114930002", "anchor": "fb-693114930002", "service": "fb", "text": "Ellen, thanks for the video. I learned a lot.
Jeff, your argument is accurate for fevers. It's positive and adaptive in most cases. Your body is trying to make it too hot for the microorganisms that it's fighting. Generally speaking, when you use medication to reduce a fever, you make yourself more comfortable in the process, but your sickness will last longer. Of course, in extreme cases the fever can go too far, but in most cases you're better off leaving it alone.", "timestamp": "1413691186"}, {"author": "Rachel", "source_link": "https://www.facebook.com/jefftk/posts/693101816282?comment_id=693131312172", "anchor": "fb-693131312172", "service": "fb", "text": "The original swelling is from all the white blood cells rushing to the site to help. Your blood vessels sort of expand and make gaps so the white blood cells can go through the holes to the damaged tissue. And the above comment about fevers: my mom used to say that as long as we could bear the discomfort not to take anything, because it was our body trying to heal. If we took something we would feel better, but we wouldn't actually BE better.", "timestamp": "1413712157"}, {"author": "Debbie", "source_link": "https://www.facebook.com/jefftk/posts/693101816282?comment_id=693146851032", "anchor": "fb-693146851032", "service": "fb", "text": "Rachel, my mom said the same thing. And I think it's probably what I say to my kids now.", "timestamp": "1413731250"}, {"author": "Mac", "source_link": "https://www.facebook.com/jefftk/posts/693101816282?comment_id=693153807092", "anchor": "fb-693153807092", "service": "fb", "text": "Mechanical engineering theory: in the utter absence of technology, swelling helps immobilize the injury. And yeah, if the body is not overreacting, let the fever fry them little bastards.", "timestamp": "1413735780"}, {"author": "Jeff Kaufman", "source_link": "https://www.facebook.com/jefftk/posts/693101816282?comment_id=693201416682", "anchor": "fb-693201416682", "service": "fb", "text": "@Walker: Yes, that could be it. If swelling served to immobilize the joint but had some downsides for healing, then using external immobilization (a splint) while suppressing swelling would be good.", "timestamp": "1413748354"}, {"author": "Josh", "source_link": "https://www.facebook.com/jefftk/posts/693101816282?comment_id=693252963382", "anchor": "fb-693252963382", "service": "fb", "text": "I had the vague impression that blodflow heals, and swelling interferes with bloodflow (but helps with immobilization), so if you can immobilize without swelling, you can get more healing bloodflow without any downside. But, that's a pretty vague impression.", "timestamp": "1413769965"}, {"author": "Daniel", "source_link": "https://www.facebook.com/jefftk/posts/693101816282?comment_id=693271710812", "anchor": "fb-693271710812", "service": "fb", "text": "It seems that there are a lot of questions/musings on this thread that are already answered in the first post video...", "timestamp": "1413776517"}, {"author": "Jeff Kaufman", "source_link": "https://www.facebook.com/jefftk/posts/693101816282?comment_id=693291925302", "anchor": "fb-693291925302", "service": "fb", "text": "@Daniel: Most people don't watch video links in discussions.", "timestamp": "1413799781"}, {"author": "Ellen", "source_link": "https://www.facebook.com/jefftk/posts/693101816282?comment_id=693293207732", "anchor": "fb-693293207732", "service": "fb", "text": "@Jeff: I posted the video as the first comment to your questions, and it covers most of the follow up questions people have asked. A written comment containing all the information the video holds would be about five paragraph, and most people don't appreciate responses that long on their discussions.", "timestamp": "1413803430"}, {"author": "Jeff Kaufman", "source_link": "https://www.facebook.com/jefftk/posts/693101816282?comment_id=693297519092", "anchor": "fb-693297519092", "service": "fb", "text": "@Ellen: The problem is lots of people (including me, most of the time) are using their computers in places where they can't listen to sound. I'm not saying you should have transcribed the video because that's lots of work (though a five paragraph summary would have been very much appreciated, if you were up to it) but in general text links work better for text discussions.", "timestamp": "1413806862"}, {"author": "Kiran", "source_link": "https://www.facebook.com/jefftk/posts/693101816282?comment_id=693297618892", "anchor": "fb-693297618892", "service": "fb", "text": "Using their computers in places where they can't listen to sound using their Bluetooth headsets.
I don't like videos because the speed of information delivery is too slow.", "timestamp": "1413806945"}, {"author": "Daniel", "source_link": "https://www.facebook.com/jefftk/posts/693101816282?comment_id=693324455112", "anchor": "fb-693324455112", "service": "fb", "text": "I'm not surprised that not everyone watched a 10-minute video, but I did think it was worth mentioning when people were all wondering and guessing at things that had already been conclusively answered by an expert.", "timestamp": "1413826579"}, {"author": "Brenton", "source_link": "https://www.facebook.com/jefftk/posts/693101816282?comment_id=695305784512", "anchor": "fb-695305784512", "service": "fb", "text": "My understanding of the answer to this (which I'm writing as procrastination one month out of my last med school exams) is it is a good idea to reduce swelling in simple trauma because it hurts. The response of 'inflammation' is what we're talking about here, which leads not just to swelling, but to heat, redness and pain (calor, rubor, dolor and tumor in textbooks). Inflammation is the body's response to every insult, both infection and physical damage. It's a really blunt instrument which is adapted for both of those. There are changes resulting in recruitment of white cells, the flow of lymphatics, heat regulation, expression of chemicals that sensitise neurons to pain and a bunch more (you can get a feeling for that by flicking through this: http://en.wikipedia.org/wiki/Inflammation). The heat, the changes in fluid drainage and white cell recruitment make more sense in the case of infection than they do of injury; it's a blunt instrument. Because we're wired to be very anti-getaninfectionanddie, the response is going to be over-blown for our current environment and also overblown for simple trauma unlikely to be accompanied by infection. The main problem with it being overblown in the short term is the pain accompanying inflammation. Given that, the guideline to reduce the inflammation in non-risky circumstances like this seems justified and useful.
Regarding fever, the reason one would reduce it is the same (discomfort), but is probably less justified than with simple injury because it might be dangerous to do so. If it goes really really really high then it can be dangerous but I don\u2019t think that's where it's most used. I do suspect that much of the lay advice on reducing fevers, particularly in kids, is misplaced because it in part comes from with febrile seizures. Febrile seizures, which happen to kids, are pretty common and pretty scary for the parents and some people thought they caused epilepsy. Anti-fever drugs used to be given to bring down the fevers to avoid them, but we now know for sure that they don't work.
Treating fevers with anti-pyretics=mostly unjustified, most of the guidelines you'll read for treating febrile conditions won't advise treatment
Treating simple injuries with rest, ice, compression, elevation and anti-inflammatories=mostly justified, guidelines will advise treatment", "timestamp": "1415231201"}]}