What’s normal? What’s not?
 Decoding common body oddities.

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Bryan Nelson, MD

There may be times when a substance, sound or sensation of your body can take you by surprise and lead you to think, “Am I normal?” Here’s a look at some common curiosities to know what is normal, and when medical intervention may help.

EARWAX
Normal: Also known as cerumen, earwax helps self-clean the ear with protective, lubricating and antibacterial properties. Old earwax moves from the ear canal to the outer ear, where it dries, flakes and falls out. Typically ear canals should never need to be cleaned, so put down that cotton swab!

Not normal:
If earwax accumulates, which could be caused by “cleaning” with a cotton swab (this can actually push wax deeper), it can lead to earache, partial hearing loss, ringing in the ear, itching and/or odor. Over-the-counter ear drops may help soften the wax, but if home treatments aren’t successful, a physician may prescribe ear drops or use a special vacuum to remove earwax.

Lesson for prevention: Cotton swabs can do more harm than good for your ears.

HICCUPS
Normal: Hiccups are involuntary contractions of the muscle that separates your chest from your abdomen (known as the diaphragm). Each contraction is followed by a quick closure of your vocal cords, and the “hic” sound is produced. Causes may be eating too much, carbonated or alcoholic beverages, sudden temperature changes, swallowing air or excitement/stress. Hiccups typically last only a few minutes.

Not normal: Hiccups fall into the not normal category if they last more than 48 hours or are severe enough to affect eating, sleeping or breathing. Long-term hiccups should be evaluated by a physician, as they could indicate damage to nerves or a metabolic disorder.

Lesson for prevention: Eat smaller meals, go easy on carbonated beverages and alcohol, and try to avoid sudden temperature changes.

ITCHY MOUTH
Normal: If you have seasonal allergies, it can be normal to have an itchy or scratchy feeling in your mouth after eating certain raw fruits and vegetables. Called oral allergy syndrome (OAS), the reaction is caused by an allergic response to the pollen that crosses over to similar proteins in the foods. Common pollen-food associations include:

Birch: apple, carrot, peach, plum, cherry, pear, almond, hazelnut
Grasses: tomato
Ragweed: melon, kiwi, banana, zucchini, cucumber

Not all seasonal allergy sufferers experience reactions to foods that mimic the pollen, and most cases of OAS are mild. Symptoms usually resolve after the food is swallowed or removed from the mouth.

Not normal: If eating a food causes hives on the skin, swelling around the mouth, nausea or trouble breathing (anaphylaxis, which can be life-threatening), seek medical attention right away.

Lesson for prevention: Cooking raw vegetables and fruits typically breaks down the proteins that can cause OAS. Get allergy testing (a skin test by an allergist) so you and your doctor can develop a plan to avoid severe allergic reactions.

Bryan Nelson, MD, is a primary care physician at Hennepin’s new Golden Valley Clinic. “I get questions like this from patients nearly every day,” says Dr. Nelson. “I think it is very important that patients are paying close attention to their health. Any reports of something different that normal could be the first sign of something more serious, even if it is mild. Often symptoms are vague at first. How they progress can direct us to a more refined and accurate diagnosis.”

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