Wow, Mrs. W., I have a lot of mail to answer from you. I
don't mind at all though. I love to hear from you and from
all my correspondents.
She asks: When do you go to the emergency department and when
do you call them?
I am afraid calling them won't do much. They will not give
information over the phone, and have no insurance coverage to
do so. The house-call doctors aren't much help either. All
kupot will gladly give you the list of acceptable
reasons to go to the emergency department, but do not ignore
the signs of heart attack or stroke, which we have reviewed
in the past.
Be prepared to sign a letter guaranteeing payment and be
prepared to fight the kupot to get reimbursed. If you
want to avoid a headache and you feel that there is no
immediate danger — get a referral letter
(hafnaya), then all is taken care of. Emergency
departments are busy places. Do not even bother with
calling.
Flu shots — get them. There is a well known shortage in
the USA, but here we have plenty and flu is not fun. It can
be dangerous to the elderly and to young people. It doesn't
cost much — 12 shekel — and is well worth it.
Headaches — migraines are due to spasm of the blood
vessels in the head, and sinus headaches are caused by filled
sinuses. The former will be a throbbing headache, the latter
a boring, constant one that worsens with head movement and
rarely has vomiting. Be careful though with unexplained
headaches. Rarely, they can be caused by leaky blood vessels
in the brain. Get it checked out.
A quick word on incontinence in adults. This can be caused by
bladder dysfunction, back problems (the spinal cord also
controls the bladder), or a large prostate. The former can be
treated by medications as can the latter, but the operation
to remove the prostate is the best treatment, though it is
not without side effects. Incontinence secondary to fear or
laughter is normal and of no consequence. Write me in care of
the Yated.
A message from GlaxoSmithKline, sponsor of this
column. Hey, do not forget the other vaccines. Hepatitis
A is also gruesome: expect three weeks of intense weakness
and jaundice. Better to get the vaccine from Glaxo.
