Diplomate, Board Certification of Emergency Medicine
Chairman, Department of Emergency Medicine Ma'ayenei
Hayeshua Hospital
Because of phone calls, letters and personal visits of
people requesting medical information, I will use this
week's column to answer, albeit briefly, these requests.
Many people in Israel live in towns where construction is
still going on. I've discussed in the past the danger of
playing in such sites, but one thing that amazes little
children is the bright white of arc welding. Welders know
that this light should only be viewed through polarized
glass. Failure to do so can cause the development of painful
burns in the cornea, which usually take 6 hours to develop.
Children must not come close to metal workers or welders.
Splinters are a common summer problem. Foreign bodies in the
skin made of glass, metal or plastic are nonreactive, and
removal can be delayed a reasonable amount of time. In some
places in the body and with small foreign bodies, removal
may be unnecessary at all. On the other hand, wood, sand and
dirt are reactive, and should be removed; although removing
wood by yourself can result in disintegration of the wood,
or leaving pieces behind, which will result in infection.
These may be hard to find and an exploration of the flesh is
necessary. They do not show up on X-ray. Ultrasound is
better.
I've been requested yet again to discuss epidurals for
childbirth and I am afraid I cannot condemn the practice.
Childbirth is painful and epidurals have a remarkable safety
record. I believe that women should be allowed to choose as
they please as far as this practice is concerned.
Constipation in a young adult is rarely serious. While it
can be seen in inflammatory bowel disease such as Crohn's
disease or ulcerative colitis, it is often due to dietary
indiscretion, such as a diet high in fats and low in
vegetables, a nervous stomach or in irritable bowel
syndrome. A high fiber diet is healthy for everyone,
especially in preventing colon cancer, and fruits remain the
best laxative. Dependence on laxatives can cause laxative
abuse, a case where the treatment may be worse than the
disease. Chronic constipation deserves a workup.
Finally, I received a very nice letter from my good friends
and former chavrusa, the R. family of Bnei Brak
asking about sun exposure. If you hail from a North American
or European country and are fair skinned, then you are at
risk for skin cancer. Most skin cancers are localized and
seen in old people, and simply removing the cancer ends the
problem. The real scary part is melanoma, a cancer of the
pigment glands, which spreads rapidly, can hide in inner
orifices of the body, such as the rectum, hair or in the
retina, and which is often la oleinu lethal.
Look out for black or purple irregular skin spots. If in
doubt, have a dermatologist have a look. If caught early,
melanoma is curable. Curbing sun exposure by wearing hats,
sunscreen of greater than 15 SPF, and avoiding tanning at
all costs is protective from this cancer.
I must say that while all men and women should be trained to
check their bodies for any unusual lumps which can be a sign
of cancer, checking spots can catch early skin cancer and
occasionally leukemia as well. Mrs. R., I will give future
live lectures on medicine by special request groups.
I love hearing from my readers, and I am elated to hear this
column is helpful to you. Please continue writing to me in
care of the Yated.
A message from Glaxo, sponsor of this column. Zeffix
is for chronic hepatitis. Hepatitis B has been a subject of
our columns in the past, and it is spread by blood
transfusion, or exposure to human secretions. It can
occasionally turn into a chronic infection and treatment is
difficult. Zeffix could be the answer. From Glaxo.
