Dei'ah veDibur - Information & Insight

A Window into the Chareidi World

22 Teves 5761 - January 17, 2001 | Mordecai Plaut, director Published Weekly








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Home and Family
Your Medical Questions Answered!
by Joseph B. Leibman, MD

Diplomate, Board Certification of Emergency Medicine

Chairman, Department of Emergency Medicine Ma'ayenei Hayeshua Hospital

Before we continue to speak about the lungs, two safety tips must be mentioned. We have been seeing a sharp upsurge in corkonet (scooter) injuries. Children are suffering serious head injuries and broken arms from falls from these riding toys. A helmet is necessary, and scooters are not designed for small children or for going down big hills. Falling on one's shoulder and rolling may prevent more injuries than on an outstretched arm. Parents: please buy your children helmets or have your local council consider subsidizing them.

Another safety issue is people who drive with children on their laps. Children need to be in safety belts or baby seats; anything less is very, and I mean very, dangerous. Don't be foolish.

Infections can happen to the lungs despite all their defense mechanisms. You only need five small bacteria or viruses to get an infection, and the average sick person coughs out millions in a single cough. Sick people who are careless about covering their mouths when they cough or who wipe their face or hands on communal towels are spreading disease.

Viruses are by far the most common cause of lung infections. Fever or green sputum do not mean that the cause is not viral. There is no treatment for most viruses, with the exception of the flu virus, and antibiotics will certainly not help. Antihistamines are also not a good idea as they dry up secretions and make them harder to get out.

Bacteria do cause lung infections, most commonly pneumonia. An x-ray is the easiest way to tell if there is pneumonia, but it can take some time to show on the x-ray especially if the patient is dehydrated. Even in the absence of a positive x-ray I would probably treat very young or very old patients with fever and cough and shortness of breath. In these high risk groups, Zinnat, a drug made Glaxo, by our sponsor, is an excellent idea, as it covers most bacteria that go to the lung. Many of these patients need to be admitted to the hospital. In lower risk patients, drugs of the erythromycin class are the first line, and there are now four in that class.

Cough gets out secretions and bacteria. It is extremely hard to suppress cough and I'm not sure you should try, but dextromthorphan containing medications probably work the best, even though they don't work that well. Vaporizers may help, but there is no evidence that forcing fluids does anything.

Before we say good bye for the week, I try to answer all our mail, and one of our readers asks why doctors have such terrible handwriting. This has never been studied and maybe it should be, but doctors tend to be very busy and also people whose minds work a lot faster than their hands, so they often write fast and sloppily. Good penmanship takes time to do and that is why I believe we have such bad handwriting. The editors of Yated make me (and every regular contributor) type my column--I wonder why? Write me in care of the Yated.


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