A Johns Hopkins Medical School physician has joined the lengthening line of "discoverers" of more or less frivolously acquired ailments ranging from Rubik's thumb (sore from pushing on the cube) to jogger's frostbite (male or female--in very delicate places) to Space Invaders elbow.

These usually environmental ills have as their great-grandmother the "syndrome" known as housemaid's knee. But because they are quite real, these side effects of modern civilization have found a home in the letters column of the New England Journal of Medicine.

Dr. Alan Pestronk, a Hopkins neurologist, started swimming three times a week, he wrote NEJM, to "combat aging." (He's 36.) He noticed that an hour or two after swimming he would get a throbbing, one-sided headache and he wrote that he "became particularly alarmed" when his next-to-last headache was preceded by a "full homonymous hemianopia with scintillations." Who wouldn't be concerned? (Although anybody who ever had a migraine can correctly guess those terms basically boil down to pre-headache "aura.")

But that was when the neurologist turned to his sporting-goods retailer dad, who made the final, accurate diagnosis: His swimming goggles were too tight.

Pestronk the younger named his headache "Goggle Migraine," and ended his letter to NEJM with the observation that "consultation with one's parents may provide valuable information."

Some parents might have observed something like, "for this I sent him to medical school?" In any case, a switch in goggles ended the headaches, scintillations and all.


Representatives of some of the area's major centers for research and treatment of the eating disorder known as "bulimia" will participate in a "Community Forum" on the problem Feb. 21, 7 to 9 p.m., at the Preterm Center for Reproductive Health.

The disorder, recently linked to hypoglycemia in some cases, is considered at near-epidemic levels among young women in high school and on college campuses. Some men and boys may also be afflicted.

Bulimia is characterized by a preoccupation with food and being thin, food binges followed by self-induced vomiting and/or laxative abuse and striving for perfection in appearance, work, school and relationships. Bulimics often look healthy and are rarely overweight or underweight, although they always believe they have a "weight problem."

Speakers at the forum will include representatives of the Growth Center for Women and the Georgetown University's Diet Management Center. The Preterm Center is at 1190 19th St. NW, Suite 200. For more information, call 452-8400, or diet counselor Dodi Ardalan, 281-0362.


Finally, a late word on the still popular Cambridge Diet--the 330 calories-a-day powder sold only through special (but mostly non-medical) counselors. Most physicians agree with a statement from the Food and Drug Administration issued Dec. 30, 1982, holding that the use of very low-calorie diets "should be considered experimental and patients should have full knowledge of the risks, and undertake the diet only with proper medical supervision."

The FDA also warned that "it has not been possible to exclude the Cambridge diet as a contributing cause" in the illnesses (requiring hospitalization) of four people and the deaths of six, all of whom had been on the diet for various lengths of time. At the same time, said the FDA, "it was not possible to clearly associate the diet" with either the illnesses or the deaths.

Dr. William Helvey, medical director for Cambridge, says that the FDA's statement was "reasonable," although Cambridge surveys indicate no link whatsoever between the diet and any serious sickness or death. "The FDA has a responsibility to be concerned," says Helvey, "and they are reflecting their own experience with the liquid protein diets of the late 1970s."

The FDA document "reemphasizes that extremely low-calorie diets should be considered to be physiologically unsound until such time as further research may demonstrate the limits of their safety and possible usefulness for rapid weight reduction."

Helvey says that further research is underway in universities in this country to document the diet's usefulness, if not as a single source of nourishment, at least "as the cornerstone" of a slightly higher-calorie diet.

It might be prudent to wait for the outcome of these studies or at least to use the 330 Cambridge diet as no more than a supplement within, say, a 1,000-calorie-a-day diet, rather than a single daily meal.

Meanwhile, the Center for Science in the Public Interest and the National Women's Health Network have issued a joint warning on over-the-counter diet pills containing PPA (phenylpropanolamine), which most of them do.

The drug, the two consumer groups warn, has "the potential for altering brain function and producing cardiovascular crises." It also doesn't work very well. Studies have shown, the groups say, that "a consumer can expect to lose about two pounds a month as a result of taking the drug, which is not recommended for use longer than three months total."

For more information, write: "Hazards Clearinghouse for PPA-Diet Pills," CSPI, 1755 S. St. NW, Washington D.C. 20009, or phone (202) 332-9110.