Diplomate, Board Certification of Emergency Medicine
Chairman, Department of Emergency Medicine Ma'ayenei Hayeshua
Hospital
I was able to speak to another ENT on the subject of olive
oil in the ears, and Dr. Tal, an English-speaking ENT at Tel
HaShomer, is a big believer in it for prevention of wax
buildup. It seems to perform as well as wax in lubricating
the ear canal and controlling the overgrowth of the normal
bacteria that grow there. Two points need to be made: it
won't dissolve the wax that clogs up an ear, and furthermore,
it isn't clear to me how it prevents buildup just because it
serves the same purpose. We'll continue researching this
subject and be in touch.
Pregnancy emergencies is our subject, and we discussed
trauma. One of the complications of seemingly minor trauma is
the problem called abruptio, where the placenta tears off the
uterine lining. This could cause bleeding, fetal demise or
clotting problems in the mother due to the release of factors
that use up the clotting materials. This last problem is
known as DIC and can be quite difficult to handle. Also it
should be made clear that this tear can be in the upper part
where the bleeding will not be noticed. The test of choice
remains monitoring with a fetal monitor. Abruptio is usually
a problem only in the third trimester.
Despite this problem, seat belts are still imperative in
pregnancy and they save lives. The seat belt is fastened
underneath the abdomen.
While bleeding from abruptio is not the only cause of
bleeding in pregnancy, it is a reason to be careful about Rh
problems. Bleeding in pregnancy can come from trauma,
miscarriage, placenta previa (we'll discuss this), or because
of rotation of the fetus. If the mother has a blood type that
is called Rh negative-- meaning that she does not have
specific material in her blood type--and the baby does have
it (the baby can get it from the father), then the mother's
blood may recognize the Rh factor as a foreign invader and
attack all blood cells with this type. What would result is
that the baby's blood cells are attacked and destroyed.
To prevent this, if any bleeding is noted and the mother is
known to be Rh negative, Rhogam is given. This medication
acts to "hide" the Rh type from the mother and prevent it
from being recognized as an invader. Establishing your Rh
status is just one of many reasons why prenatal care is
essential.
This will be the recurrent theme in this article. Poor or no
prenatal care causes more problems for the doctor and could
result in disaster. Write me in care of the Yated.
A message from Glaxo, sponsor of this column.
Parkinson's disease can be a tough management problem.
Finding the right treatment needs to be individualized.
Requip is Glaxo's contribution to the field and results have
been very encouraging both in effectiveness and side effect
profile. Requip should be considered for use for those
suffering from this disease.
