Mono Lisa: Tell Epstein-Barr to kiss off
Growing up, I wasn't encouraged to listen to rock-n-roll or pop music. Before my mother became a physician, she sang opera, so I was exposed to classical music, jazz, and show tunes. (Ask my patients. If they leave after a visit without hearing me sing something, I often get a frowny face. But then again, I often get a frowny face when I do sing something.)
In those days, I wanted to be a musician or a music professor. I still think I could have been one of the world's greatest lyricists. Give me a melody, and I can come up with lyrics as easily as baking a cup cake in an Easy-Bake-Oven. I'm like Wayne Brady on Whose Line Is It Anyway?
My question is why are there so many songs on love and kissing? Can kissing be a hazard?
Prince: "I just want your extra time and your– smooches– smooches-smooches– kiss!" Faith Hill: "This kiss, this kiss, unsinkable." Pearl Jam: "I held her close; I kissed her our last kiss." Sinatra: "In other words, hold my hand. In other words, baby kiss me." (That doesn't even rhyme!) Whitney Houston & Enrique Iglesias: "Could I, could I have this kiss forever?" (Bleh!)
Don't you know you can catch oral herpes (aka "cold sore") or "mono" from kissing? If I were a lyricist, I would write something like, "I kissed you, and for one month I thought I was going to die. A sore throat, a fever, fatigue, swollen glands– made me want to cry. Then my spleen ruptured and I almost died. So, baby, darling, don't kiss me, good-bye!"
Infectious mononucleosis– commonly known as mono– is caused by the Epstein-Barr Virus (no relation to Roseanne) which is a type of herpes virus. It's not genital herpes, so don't freak out, because you most likely have been exposed to Epstein-Barr Virus (EBV). Of adults tested by blood, 90-95 percent have antibodies that show previous exposure. The virus is transmitted by saliva through close contact, such as sharing a drinking glass, silverware, and... kissing.
On average, symptoms occur one to two months after exposure, but it can show up as long as 18 months or more later! That's why most people who present with mono deny being exposed to anyone who was sick. "Honestly, Dr. Hong, I have not sucked face with anyone new in 18 months... I think."
Of children exposed to EBV, less than 10 percent will actually get sick. Of adults exposed to EBV, about 50-70 percent will get sick if they weren't already exposed to it as a child.
The triad of sore throat, fever, and swollen lymph nodes characterizes mono. People usually feel fatigued a day or so before the fever and sore throat. The back of the neck has tender lymph nodes (aka glands), but the front of the neck and armpits do, too. The throat is beet red, and the tonsils might have some white or gray discharge, which can be confused for strep throat. If the tonsils get too swollen, ironically we call them "kissing tonsils." (Is that like kissing cousins?)
In half of the people with mono, the spleen in the upper left of the abdomen will enlarge. The enlarged spleen can press up against the stomach and curb the appetite. (No, you cannot enlarge your spleen on purpose to lose weight. Exercise.)
If it's hit hard– or sometime even without any trauma– the spleen can rupture and require emergency surgery. Therefore, no contact sports or activities where an abdominal blow is possible are advised for at least a month after onset of the symptoms.
There is no cure for mono, and treatment is just for symptomatic relief. If someone has kissing tonsils, steroids can reduce the inflammation. Fluids and rest for one to two months are needed during recovery, and the invalid can always listen to Nat King Cole sing "Mono Lisa."