"Leaves three - turn and flee." (preventing and caring for poison ivy exposure)

The old adage for avoiding poison ivy still holds. Although not all plants with only three leaves are poisonous, if you or your children don't know what poison ivy looks like, ask someone who does to take you on a nature walk until you run across some.

Study the plant carefully, both in its early stage, with its peculiar coloring, and in its bright green mature stage. Know where to look for it--a vine growing along the ground or up the trunk of a tree. Get acquainted with poison oak and poison sumac, too, however less common they may be in your particular neck of the woods.

If you know you're sensitive to poison ivy, be especially careful while walking in unfamiliar areas--and while working in your own yard. When you find it on your property, don't try to pull it up unless you're absolutely sure that your hands are protected by disposable gloves and that you're wearing a long-sleeved shirt. The offending oily substance in poison ivy clings readily to anything that touches the plant and is readily transferred from there to one's skin.

If you choose to pull up the vine, place it in a suitable trash container for disposal. Never burn it--the offending agent travels far in the smoke. It's better to just spray the stuff on site with a recommended herbicide and let it die.

So you've made it well into adulthood without ever succumbing to its evil effects. Obviously, you must be immune to it. Wrong! Your editor so assumed some years ago until, one fateful day with gloved hand but bare arm, he swept a pile of leaves into a trash bag--and a few days later developed a rash from the wrist upward. The rash soon became a mass of itching, oozing sores that sent him scurrying to his friendly dermatologist, certain that he had come down with some rare tropical disease during his recent trip abroad.

If you are exposed, wash immediately with plenty of water and soap. If a rash develops, resist the temptation to scratch it when it itches. If tepid baths, cool wet compresses, Burrow's solution, or Domeboro don't improve the situation, ask your doctor to prescribe a strong hydrocortisone cream.

Cortisone creams available over the counter are inadequate. And don't use antihistamine creams, benzocaine, or antibiotic creams with neomycin sulfate, all of which can worsen the rash.

Really serious cases require oral steroids, prescribed over a period of ten days or more, starting with a large dose and gradually tapering off to a very small dose at the end. The result can be surprisingly satisfactory!

The old-fashioned "sitz bath"--just sitting in warm water for a while several times a day--does wonders for hemorrhoids that are acting up, and ordinary nonpetroleum lubricating jelly is useful for applying to the anal area. Apply it gently with the finger to the anal rim, not into the anus, at which time protruding hemorrhoids can be gently pushed back beyond the anal sphincter (valve).

A less common form of hemorrhoid is one that originates outside the anus, from a clot forming in a small vein--usually the result of sudden, strenuous activity. Although painful, they usually take care of themselves in less than a week, even without treatment. If they persist, however, a simple office procedure can be used to remove them.

Other office procedures for persistent hemorrhoids include:

An injection of a drug that shrinks the enlarged blood vessels. This will usually take care of hemorrhoids that do not protrude through the anus for a year or two at a time.

A rubber band. Placed around a protruding hemorrhoid, it will destroy the hemorrhoid by cutting off its blood supply, so that it simply falls off by itself in about a week. (Not a home remedy, however!)

Photocoagulation. For either kind of hemorrhoid, this procedure, which uses infrared light at the end of a probe, is more painful but provides less painful recovery.

Finally, if any of these office procedures is not suitable, outpatient surgical removal under local anesthesia is available. Although laser surgery is often promoted as being less painful (and providing more rapid recovery), some recent studies have disproved this--and one has even shown that laser surgery results in more postoperative inflammation.