Specialist In Emergency Medicine
A writer sent me an article about psychotherapy for
hypochondriacs. Indeed, hypochondria is a tough illness, and
these folks often shift from emergency ward to emergency
ward, getting half-baked treatment and taking their show on
the road to another ward that does not know them. Indeed, the
fact that psychotherapy helped is welcome, although in
general, psychotherapy has been a disappointment. Sometimes
it is all we have, but that isn't to say that I do not
believe that some rabbis have more talent in this area than
well-trained psychologists.
Another letter brings an article about self-hypnosis to cure
chronic cough. A neat idea, but I am afraid the study group
was too small to make any conclusions.
What is phlebitis? It is a disease of the veins. When veins
become clotted off -- and we are speaking about deep veins --
it is called a DVT and carries with it a danger of a clot
breaking off and lodging in the lungs, which could be lethal,
aside from being extremely hard to diagnose. The treatment is
anticoagulation, that is thinning of the blood with
medication. It is often associated with other conditions such
as pregnancy, long travel, surgery, and cancer. It can occur
in the upper limbs as well where it is harder to diagnose.
When it is in the superficial areas it is called SVT or
phlebitis. These painful clots are near the surface and
respond well to warm soaks and anti-inflammatory medication.
These are common after pregnancy. When they get infected,
there is a need for antibiotics.
Veins sometimes become incompetent due to valve failure, and
blood backs up. This can be painless, but result in leg
swelling and varicose veins. Long term disease can result in
permanent leg swelling, discoloration and recurrent infection
-- called in Israel Shoshana, but in medicine erysipelas. The
easiest way to evaluate this disease is ultrasound. Let me
just say that this is not the same as a clot in the arteries
which is catastrophic. This needs immediate opening of the
artery.
Diabetics often have disease of the blood vessels, and can
end up with amputations due to bad blood supply and chronic
infections. Write me in care of the Yated.
A message from GlaxoSmithKline, sponsor of this
column. Dermovate and Eumovate are treatments for eczema,
the redness and scaling that often appears behind children's
ears and in elbow folds. They work well and quickly too, and
are safe. Ask your dermatologist.
