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In Charles Dickens' A Christmas Carol, the character Tiny Tim is affected by a mysterious, never-defined illness characterized by symptoms of short stature, weakness, and the necessity of a crutch and iron limb supports. Notably, the disease is both fatal within 1 year but also reversible, being altogether eliminated following Scrooge's assistance. What is the most likely diagnosis?
Several studies have been conducted to attempt to identify the cause of Tiny Tim's illness. Russell W. Chesney, MD, argues that a combination of tuberculosis (TB) and rickets brought on by environmental factors is the culprit, writing that "the combination of rickets and TB represent a crippling condition that could be reversed by improved vitamin D status."1
Donald W. Lewis, MD, suggests instead that renal tubular acidosis (type 1), "a disorder that is characterized by growth failure and, if left untreated, complicated by osteomalacia with pathologic fractures, hypokalemic muscle weakness and periodic paralysis, nephrocalcinosis leading to renal failure, and death," was behind Tim's illness.2
References:
1. Chesney RW. Environmental factors in Tiny Tim's near-fatal illness. Arch Pediatr Adolesc Med. 2012;166(3):271-275. doi:10.1001/archpediatrics.2011.852
2. Lewis DW. What was wrong with Tiny Tim? Am J Dis Child. 1992;146(12):1403-1407. doi:10.1001/archpedi.1992.02160240013002
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Education costs money but ignorance costs more
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yoghurt x fav x anxty
These are the foods that can reduce the symptoms of anxiety.
Improving gut bacteria can help to decrease anxiety, a review of the research finds.
Both a balanced diet and using probiotics can help improve gut bacteria.
However, eating more fruit and vegetables may be the best way to improve gut bacteria, rather than using probiotic supplements.
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STAIR CLIMBING X REDUCE BP
Around half of all Americans have high blood pressure.
Climbing the stairs can help to reduce blood pressure, recent research shows.
Stair climbing also helps reduce arterial stiffness and increases leg strength.
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NYR21 - I WILL START TO EAT HEALTHY AND WALK10K
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You must not merely tolerate uncertainty, you must savor it. Or you won’t last long.”
-Peter Leschak
"Silence is a strange thing to us who live: we desire it, we fear it, we worship it, we hate it. There is a divinity about cats, as long as they are silent: the silence of swans gives them an air of legend."
-- Keith Douglas, Alamein to Zem Zem
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BORLAND "Knowing trees, I understand the meaning of patience. Knowing grass, I can appreciate persistence
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-- Author Unknown
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