Tickling not a laughing matter for some

By DR. MITCHELL HECHT - McClatchy Newspapers

Question: Why do people laugh when they’re being tickled? For me, it’s definitely not an enjoyable experience!

— A.T., Brooklyn, N.Y.

Answer: Tickling is no laughing matter! The laughing associated with tickling is actually a response to a painful stimulus of sorts.

It is said that tickling was a form of medieval torture, where prisoners died at the hand of a feather through the unrelenting tickle.

The withdrawal response to the light touch of a tickle is believed to be a primitive protective mechanism against spiders and bugs. That’s why the most vulnerable body areas — the feet, armpits, abdomen and ribs, are typically the most ticklish.

For some people, the mere threat of being tickled elicits a laugh. Some folks can inhibit the stimulus and just aren’t ticklish.

It’s not clear why there’s a paradoxical laugh response to an unpleasant stimulus. Some researchers believe the laugh encourages a healthy bond of communication between the tickler and ticklee.

It might be a form of good social behavior, despite its unpleasantness. Chimps and humans tickle during play, and tickling for some can be a form of flirtation or foreplay.

I’m afraid that these are all theories, and there’s no one that we can “tickle torture” to reveal the answer to one of life’s mysteries.

Question: I have had several leg clots and episodes of phlebitis beginning 34 years ago. When I described my history to my new doctor, he ordered a number of lab tests to try to explain why I’ve had so many leg clots. Two of the blood tests, a protein C level and a protein S level came back very low. My doctor said that this may explain things and he has recommended that I see a hematologist. Can you explain what it all means?

— R.M., Roswell, Ga.

Answer: There’s normally a balance between the factors that keep our blood from clotting and those that allow our blood to clot when broken blood vessels bleed.

Protein C and protein S help to prevent excessive blood clotting from occurring. If there’s a deficiency of one or both of these proteins, there will be an increased risk of clot formation (thrombosis) in veins.

There are, however, a number of folks who unknowingly have decreased levels of protein C and S without ever having an abnormal blood clotting event like a deep venous thrombosis (DVT) of the leg.

Fortunately, neither of these conditions is particularly common, with protein C deficiency occurring in 1 in 200 to 1 in 500 folks in the general non-symptomatic population. The incidence of protein C deficiency causing clots is between 1 in 16,000 and 1 in 32,000 folks. The incidence of protein S deficiency occurs in approximately 1 in 700 non-symptomatic folks.

While protein C and S deficiencies are usually inherited disorders of clotting, if someone is on a blood thinner like Coumadin or heparin, the protein C and S levels will be falsely low. I’d agree with the advice that you see a hematologist to further evaluate your clotting disorder and to discuss whether long-term anticoagulation with Coumadin is advisable given your repeated blood clots.