Puffy Bug Bites and Unlikely Organ Transplants: A Pediatrician Answers An 8-Year-Old

8 year olds ask questions
Eight-year-olds demand answers.

If you have an 8-year-old in your life, you know they ask a lot of questions. On any given day, the one in my life asks questions about volcanoes, gold, the growth rate of bamboo, the tensile strength of various household objects, swordfighting, which animals would win in contests of speed and strength with other animals (and humans), and how long children can hold breath underwater versus adults, other mammals and other members of the animal kingdom.

Even wackier questions that crop up after a visit to the doctor:

  • Do we need our whole brain to live?
  • What’s the deal with fevers? Why do we stay home if we have them?
  • Why do my nails grow if they’re dead, and why don’t they hurt when I cut them?
  • Why do bug bites get itchy and puffy?
  • Why do we transplant hearts but not stomachs?

Angelique Redus-McCoy, MD, pediatrician at UVA and mother of an 8-year-old, was a good sport in the age of Google and answered these questions in detail and with humor. Redus-McCoy first thought she wanted to be a doctor when she was a third grader. In high school she predicted that she’d be a pediatrician in 10 years. She was right.

“I chose pediatrics because I love children’s spirits and their sense of resiliency,” she says. “At the end of the day, they just want to play.”

Do we need our whole brain to live?

Redus-McCoy: The different parts of the brain — the cerebellum, cerebrum and brain stem — each do different things, but the things they do overlap. Even neuroscientists don’t know the exact percentage of how much of our brain we need to survive and function.

A person can survive and function with half of his or her cerebral cortex, for example. Some brain injuries can cause death or change aspects of someone’s personality or ability to learn, while others can leave a person functioning normally. The brain still has a lot of mysteries that doctors and researchers are trying to unlock.

Why do we stay home when we have fevers?

Redus-McCoy: A fever means that your body is fighting off an infection. That infection can be a virus or bacteria. Your body uses energy to fight the infection, and sometimes the body tries to burn up the infection, and that’s why you run a fever.

When an infection is strong enough to give someone a fever, it usually means that it’s contagious, so other people are in danger of getting the same infection. When you’re sick you should stay home, drink lots of water, rest and let your body fight the infection until your body temperature goes back to normal and you start feeling better.

Why do my bug bites get puffy and itchy?

Redus-McCoy: When an insect punctures, or puts a hole in your skin, the insect leaves behind venom, saliva or some other substance that your body reacts to by releasing a substance called histamine. Depending on the bug and the person, your skin might not show much puffiness or itchiness. But in many people, the histamine makes blood vessels at the puncture get big and puffy. This irritates nerve endings, and makes us itch.

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Why do my nails grow if they’re dead? Why can’t I feel them when I cut them (or bite them)?

Redus-McCoy: It’s only partially true that they’re dead. The part where your nail starts under the skin is very much alive. You can tell if you cut or bite your nails too short — it really hurts! The cells that make up your nails mature and regenerate, or keep growing, so it pushes the nail past your skin, and that’s the part you can’t feel when you bite your nails.

How come you can get a new heart (like in a transplant) but you can’t get a new stomach?

Redus-McCoy: With some other organs or body systems, like the digestive system, you can survive with only part of an organ or parts of the body system. For instance, the small intestine can compensate, or make up for, a lot of the digesting that the stomach does in cases where someone only has part of their stomach. The heart, on the other hand, is the only organ in the body that does what it does. If something’s wrong with it, there’s no other body part that can take its place.

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