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Created page with "400px|thumb|right One of the most debilitating maladies in the 21st century, '''sandwich deficiency syndrome''' (or '''SDS''') is an unfortunate but rev..."
[[File:Sandwich.jpg|400px|thumb|right]]
One of the most debilitating maladies in the 21st century, '''sandwich deficiency syndrome''' (or '''SDS''') is an unfortunate but reversible condition in which the body is starved for a food item consisting of two pieces of bread with some sort of filling in between them. '''SDS''' can lead to total body collapse including sandwich shock, a condition that differs only from septic shock in that the source is a lack of sandwich not infection.
'''Causes'''
----
Unlike the majority of diseases that have multiple causes or no known or a poorly-understood cause, the etiology of '''sandwich deficiency syndrome''' is simple: a lack of sandwich.
'''Types'''
----
Type 1 and type 2 SDS are labelled based on onset: type 1 SDS is characterized by paroxysmal onset and systemic collapse, while type 2 SDS is anything else less acute. Furthermore, both types of SDS can be further specified by the type of '''sandwich deficiency''': a general sandwich deficiency defined by treatment with any sandwich whatsoever or more specific sandwich deficiencies in which treatment is dependent on the right sandwich. The most classic example of a specific sandwich deficiency syndrome is the [[Turkey Sandwich|turkey sandwich]] deficiency syndrome. The list of specific sandwich deficiencies is long, with research unlocking new permutations of this condition. Below are some of the most common:
* Bologna SDS
* Breakfast SDS, which can include egg sandwich SDS and other variants
* BBQ sandwich SDS, which can further be subdivided into pulled pork SDS and brisket SDS
* Ham or ham & cheese SDS
* Jewish deli SDS including pastrami SDS, corned beef SDS, and numerous others
* Muffaletta SDS
* Philly cheesesteak SDS
* Po' boy SDS
'''Symptoms'''
----
'''Sandwich deficiency''' can lead to long list of symptoms, most of which are not specific to the condition alone. Symptoms can include: headache, sore throat, cough, congestion, licking of lips, chest pain, shortness of breath, emptiness, hunger pain, hanger pain, nausea, intestinal apathy, a growling stomach, a crying stomach, joint pain, muscle aches, jaundice, itchiness, and urethral discharge.
'''Signs'''
----
Vital signs can range from normal to totally out of whack, depending on the level of a patient's sandwich depletion. Important [[Physical Exam|physical exam]] findings include:
* ''Point-in-mouth sign'': patient points finger into mouth as if wanting to eat something
* ''Tummy rub sign'': patient rubs belly in a pattern resembling a hoagie or muffaletta
* ''Sandwich sign'' - patient says "I want a sandwich"
'''Diagnosis'''
----
There are several studies that can aid in the diagnosis:
*''Serum sandwich levels'': Helpful though woefully inaccurate at times
*''Serum sandwich IgG antibodies'': Lack of antibodies suggest lack of sandwiches
*''Abdominal imaging'': an abdominal X-ray, CT of the abdomen, and MRI abdomen can help reveal the presence or absence of digested sandwiches.
*''Endoscopy'': direct visualization of a sandwichless stomach or intestinal tract is highly sensitive and specific
'''Treatment'''
----
First-line treatment for a sandwich deficiency is a stat sandwich. If a patient presents with a generalized '''SDS''', any sandwich will do. If a patient is suffering from Reuben '''SDS''', then - by [[God]]! - get that person a Reuben. No matter what the intervention, the health care professional providing the intervention must never forget to document a [[Sandwich Note|sandwich note]], a form of [[Progress Note|progress note]] dedicated to the appropriate record-keeping of sandwiches.
'''Controversy'''
----
An ongoing controversy in '''sandwich deficiency syndrome''' is whether or not [[Hot Dog|hot dogs]], burgers, and lobster rolls fall under the umbrella diagnosis. Several [[Pilot Study|pilot]], [[Double-Blind|double-blind]], triple-blind, and [[Quadruple-Blind|quadruple-blind]] studies are taking place to help tease out, though the issues doesn't promise to be resolved any time in the near future.
'''Related Reading'''
----
* [[Chipotle]]
* [[Double Portions]]
* [[McDonald's]]
* [[NPO]]
* [[Sandwich Note]]
* [[Trendelenburger]]
[[Category:Food & Nutrition]]
One of the most debilitating maladies in the 21st century, '''sandwich deficiency syndrome''' (or '''SDS''') is an unfortunate but reversible condition in which the body is starved for a food item consisting of two pieces of bread with some sort of filling in between them. '''SDS''' can lead to total body collapse including sandwich shock, a condition that differs only from septic shock in that the source is a lack of sandwich not infection.
'''Causes'''
----
Unlike the majority of diseases that have multiple causes or no known or a poorly-understood cause, the etiology of '''sandwich deficiency syndrome''' is simple: a lack of sandwich.
'''Types'''
----
Type 1 and type 2 SDS are labelled based on onset: type 1 SDS is characterized by paroxysmal onset and systemic collapse, while type 2 SDS is anything else less acute. Furthermore, both types of SDS can be further specified by the type of '''sandwich deficiency''': a general sandwich deficiency defined by treatment with any sandwich whatsoever or more specific sandwich deficiencies in which treatment is dependent on the right sandwich. The most classic example of a specific sandwich deficiency syndrome is the [[Turkey Sandwich|turkey sandwich]] deficiency syndrome. The list of specific sandwich deficiencies is long, with research unlocking new permutations of this condition. Below are some of the most common:
* Bologna SDS
* Breakfast SDS, which can include egg sandwich SDS and other variants
* BBQ sandwich SDS, which can further be subdivided into pulled pork SDS and brisket SDS
* Ham or ham & cheese SDS
* Jewish deli SDS including pastrami SDS, corned beef SDS, and numerous others
* Muffaletta SDS
* Philly cheesesteak SDS
* Po' boy SDS
'''Symptoms'''
----
'''Sandwich deficiency''' can lead to long list of symptoms, most of which are not specific to the condition alone. Symptoms can include: headache, sore throat, cough, congestion, licking of lips, chest pain, shortness of breath, emptiness, hunger pain, hanger pain, nausea, intestinal apathy, a growling stomach, a crying stomach, joint pain, muscle aches, jaundice, itchiness, and urethral discharge.
'''Signs'''
----
Vital signs can range from normal to totally out of whack, depending on the level of a patient's sandwich depletion. Important [[Physical Exam|physical exam]] findings include:
* ''Point-in-mouth sign'': patient points finger into mouth as if wanting to eat something
* ''Tummy rub sign'': patient rubs belly in a pattern resembling a hoagie or muffaletta
* ''Sandwich sign'' - patient says "I want a sandwich"
'''Diagnosis'''
----
There are several studies that can aid in the diagnosis:
*''Serum sandwich levels'': Helpful though woefully inaccurate at times
*''Serum sandwich IgG antibodies'': Lack of antibodies suggest lack of sandwiches
*''Abdominal imaging'': an abdominal X-ray, CT of the abdomen, and MRI abdomen can help reveal the presence or absence of digested sandwiches.
*''Endoscopy'': direct visualization of a sandwichless stomach or intestinal tract is highly sensitive and specific
'''Treatment'''
----
First-line treatment for a sandwich deficiency is a stat sandwich. If a patient presents with a generalized '''SDS''', any sandwich will do. If a patient is suffering from Reuben '''SDS''', then - by [[God]]! - get that person a Reuben. No matter what the intervention, the health care professional providing the intervention must never forget to document a [[Sandwich Note|sandwich note]], a form of [[Progress Note|progress note]] dedicated to the appropriate record-keeping of sandwiches.
'''Controversy'''
----
An ongoing controversy in '''sandwich deficiency syndrome''' is whether or not [[Hot Dog|hot dogs]], burgers, and lobster rolls fall under the umbrella diagnosis. Several [[Pilot Study|pilot]], [[Double-Blind|double-blind]], triple-blind, and [[Quadruple-Blind|quadruple-blind]] studies are taking place to help tease out, though the issues doesn't promise to be resolved any time in the near future.
'''Related Reading'''
----
* [[Chipotle]]
* [[Double Portions]]
* [[McDonald's]]
* [[NPO]]
* [[Sandwich Note]]
* [[Trendelenburger]]
[[Category:Food & Nutrition]]
