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If you're going to sneeze, sneeze BIG! - (1/23/2018)

By Dr. Ron Gasbarro

The pharmacist heard some odd noises in the greeting card aisle. The sounds were little high-pitched chirpings. Yet, all the pharmacist could see was Rick, the big strapping captain of the high school football team. Then, she saw him do it: he would squeeze his nostrils tightly whenever he had to sneeze. After he had selected a birthday card for his girlfriend, he approached the cash register and sneezed again in the very same way. “Why do you sneeze that way?” she asked him. “Mom always said it was more polite,” Rick replied.

Sneezing is nothing for which one needs to apologize. A sneeze is an involuntary expulsion of air from the lungs through the nose and mouth, usually caused by foreign particles irritating the nasal mucosa.  Hence, it is a natural function like coughing or clearing one’s throat. One survey showed that the majority of people (59%) sneeze on average less than once daily, while 31% sneezed once or more times but fewer than 4 times a day. Only 10% sneezed more frequently, likely a result of allergies.

A robust sneeze can be satisfying. However, there is a right way and a wrong way to sneeze. The method Rick uses to sneeze can cause serious harm. A recent report, published in the British Medical Journal, illustrated the damage a stifled sneeze can do. A 34-year old male managed to rupture the back of his throat during this maneuver leaving him barely able to speak or swallow, and in considerable pain. The young man explained that he had developed a popping sensation in his neck which immediately swelled up after he tried to contain a forceful sneeze by pinching his nose and keeping his mouth clamped shut at the same time. When the ER doctors examined him they heard popping and crackling sounds, which extended from his neck down to his ribcage – a sure indication that air bubbles had been forced into the deep tissue and muscles of the chest. Because of the risk of serious complications, the man was admitted to the hospital, where he received nourishment via a feeding tube and was given intravenous antibiotics until the swelling and pain had subsided. After 1 week, he was well enough to be discharged with the advice not to block both nostrils when sneezing in future.

So if you have to sneeze, let it roar. Not necessarily into the stratosphere which will launch germs, but certainly into a tissue or the crook of the elbow. At the very least, you will get a God bless or gesundheit (German for “good health”). Speaking of German, some sneezing exclamations have accents. Americans say “ah-choo!” but Germans say “hat-schi!,” the French cry out “at-choum!,” the Russians bark “ap-chkhee!” while the Chinese shout “a-ti!”

Sneezing is not just a human activity. Dogs, cats, chickens, and iguanas warrant a “bless you” from time to time. African wild dogs use sneezing as a form of communication, especially when considering hunting as a pack. Overall, all birds and land mammals sneeze. Other animals, including fish, insects, and amphibians do not sneeze. 

The unfortunate bloke who ended up in the hospital was relatively lucky. Besides chest and throat injuries, internal sneezing can also result in a perforated eardrum or even a rupture of a blood vessel in the brain. Rick told the pharmacist that he would make every effort to sneeze in a more healthy fashion, whether it is polite or not. 

Ron Gasbarro, PharmD, is a registered pharmacist, medical writer, and principal at Rx-Press.com. Read more at www.rx-press.com     


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