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DR MARK PORTER'S A-Z OF HEALTH; PART THREE.

KEEP THE WHOLE FAMILY FIT AND HAPPY WITH MY A-Z GUIDE TO YOUR MOST COMMON HEALTH PROBLEMS. IN THIS FINAL PART YOU'LL FIND DETAILS OF SYMPTOMS, SELF-HELP AND CONTACT NUMBERS

P

PHARYNGITIS

Inflammation of the pharynx ( the part of the throat between the tonsils and the larynx) leading to sore throat. It is most commonly caused by a viral infection or swallowing substances which irritate the lining of the throat. It can be aggravated by smoking or excess alcohol.

Symptoms and signs

The main symptom is a sore throat which is accompanied by difficulty in swallowing, fever, earache and swollen lymph glands in the neck.

Self-help

Other than gargling with warm salt water and taking painkillers there is little that can be done and it normally resolves by itself. However, bacterial causes will respond to antibiotic treatment if the problem persists.

POLIOMYELITIS

An infectious disease that normally produces only a mild illness but can lead to paralysis. Polio immunisation was introduced in 1962 and is now offered routinely to all children in their first year, and again before they start school. Given as a drop on the tongue, or a sugar lump, it contains a virus that is enough like the polio virus to give immunity but not enough to cause the actual disease. Most people who contract the disease today are those who have not received the vaccination.

Symptoms and signs

Minor forms of polio are the most common and about 85 per cent of child sufferers have no symptoms. In the remainder there is a short illness with fever, sore throat, headache and vomiting. Occasionally, after a period of apparent recovery, a major illness develops which resembles meningitis and causes inflammation of the nerves. This can lead to extensive paralysis of the muscles.

Treatment

There is no effective treatment for polio. Milder forms probably need only bed rest and painkillers but if paralysis develops physiotherapy is essential to reduce muscle damage and later to maintain muscle function.

WARNING: Baby's nappies

Anyone in contact with a recently-immunised baby should have been vaccinated themselves. The tame strain in the vaccine can revert to the nastier form and be contracted by contact with dirty nappies. Catching polio in this way is extremely unlikely but, even so, anyone who changes babies' nappies must wash their hands afterwards and to be extra careful about personal hygiene for at least six weeks after immunisation.

PRE-ECLAMPSIA

A condition thought to be caused by abnormalities within the placenta.

It affects as many as one in 20 pregnancies, but is most common in first pregnancies, when it affects one in 10. Most cases are mild, but one in 100 is so severe that it threaten the life of the mother and child.

Symptoms and signs

The three features which characterise the condition are raised blood pressure, protein in the urine, and oedema, or swelling.

These problems are normally identified by regular checks during pregnancy.

If symptoms develop they may include visual disturbance, severe headache, general poorliness and pain, with or without vomiting.

Treatment

There is no cure and pre-eclampsia does not get better until after the baby is born - this means your doctor must keep a close watch on you, possibly in hospital.

The baby may have to be delivered early.

For more information

Action on Pre-eclampsia, 31-33 College Road, Harrow, Middlesex HA1 1EJ. Tel: 0181 863 3271. 24-hour information line: 01923 266778.

PREMENSTRUAL SYNDROME (PMS)

PMS is a very real condition and doctors are taking it more and more seriously. It affects nine out of 10 women in some way, but five per cent complain of such severe symptoms that their life is totally disrupted. It is due to the changing levels of hormones that occur in the two weeks before a period.

Symptoms and signs

There are lots of different symptoms. The most common is a feeling of bloatedness, tender breasts, headaches, aggression, depression and loss of control.

Treatment

The good news is that there is a lot that can be done to help. The bad news is that treatment can vary a great deal from one individual to another. I have some patients who have been cured overnight simply by taking the Pill. On the other hand, I have had quite a few for whom it has made the symptoms much worse. In my experience, successful treatment of PMS depends on two factors.

First, you need a sympathetic doctor and secondly, women need to play an active role in treatment and learn as much as possible about PMS. Many of the recognised therapies, particularly dietary changes, can be carried out by patients themselves and the more informed a woman is about such matters, the more successful she is likely to be.

For more information

Contact the National Association for Premenstrual Syndrome (NAPS) at PO Box 72, Sevenoaks, Kent TNl3 lXQ.

PROLAPSED DISC

A common disorder, also known as a slipped disc, in which the disc between the vertebrae ruptures, spilling its jelly-like inside and creating pressure on the nerve root. It affects mainly young and early middle-aged adults.

Causes

It usually develops gradually as a result of general degeneration of the discs, but can be caused by sudden strenuous activity such as lifting a heavy weight.

Symptoms and signs

Symptoms occur both in the back and in the area which the nerve root supplies. For example, a prolapsed disc in the lower back can lead to shooting pains in the legs. Painful muscle spasms around the spine can occur and the patient will feel more pain when moving.

Treatment

More than nine out of 10 people get better by simply resting and letting nature take its course. The main form of treatment is rest - ideally by lying flat in bed so that the pressure on the nerve root is minimal.

Make sure your bed is hard by putting boards under the mattress.

Painkillers can help, as can drugs which relax the muscle spasms. If this fails then an operation to remove the protruding disc may become necessary.

PROSTATE ENLARGEMENT

An increase in the size of the prostate gland, known medically as prostatic hypertrophy. The cause is unknown, but it affects more than half of men over 65 and nearly all men over 85.

Symptoms and signs

The first sign is difficulty passing urine and a weak stream. There may be a tendency to dribble and a feeling that the bladder is not empty. Men frequently find that they have to get up in the night to urinate. Left untreated, symptoms will get worse.

Treatment

It depends on how bad the symptoms are. Drug treatments work by either dampening down activity in the muscles surrounding the urethra, causing them to relax, or by preventing the breakdown of testosterone, which can shrink the gland by more than 20 per cent. More severe forms may need surgery to remove or destroy all or part of the gland. Some cases will turn out to involve prostate cancer - another important reason for seeking medical advice.

PSORIASIS

A chronic skin disorder affecting over one million people in the UK.

Symptoms and signs

It is characterised by red, scaly raised areas most commonly on the elbows, knees and scalp.

Treatment

There is, as yet, no cure but there are a wide range of available treatments and it is important for doctors to find which works best for each patient. Sunlight or artificial light treatment can also be beneficial.

For more information

The Psoriasis Association, 7 Milton Street, Northampton NN2 7JG. Tel: 01604 711129

PUBIC LICE

Tiny triangular insects - also known as crabs - that infest the pubic hair region, but can also be found in the armpits, eyebrows and eyelashes. They are nearly always spread sexually.

Symptoms and signs

The first sign is constant severe itching. The diagnosis is made by finding one of the lice. That is easier said than done - they look like small freckles, but unlike freckles can be picked off and have legs!

Treatment

You can't get rid of lice by regular washing or scrubbing - unless you use the right stuff. There are lots of different lotions available, some of which need to be applied only once. And if you really can't face your GP, some types are available from your pharmacist without a prescription.

Read the instructions carefully and treat all the affected areas and not just your pubic hair - it is highly likely that the lice will have spread to other parts of your body. Work out how you got them to make sure your partner receives proper treatment, too.

R

RHEUMATOID ARTHRITIS

A type of arthritis in which the tissues lining the joints become inflamed. A quarter of cases start before the age of 30, but it most commonly develops between 40 and 50. Women are affected three times as often as men.

Symptoms and signs

Rheumatoid arthritis usually starts gradually with red, painful, swollen joints. In time, the joints become permanently swollen, leading to stiffness and deformity. All joints can be affected, but those most commonly involved include the hands, wrists, feet and knees.

Self help

Weight reduction will ease symptoms if you are overweight. Sufferers are bombarded with special diets, but there is no convincing evidence that these can make a difference.

Treatment

Non-steroidal anti- inflammatory drugs are the cornerstone of treatment and can ease joint pain and stiffness. Anti-rheumatic drugs can be used to slow the progress of the disease and corticosteroid injections are used in more severe forms. Physiotherapy, occupational therapy or surgery to replace damaged joints with artificial substitutes are other options. Early use of oral steroids may slow the progress of the disease.

For more information

The Arthritis and Rheumatism Council for Research, PO Box 177, Chesterfield S41 7TQ. Arthritis Care, 18 Stephenson Way, London NW1 2HD.

RHINITIS

The medical term for inflammation of the lining of the nose, caused either by a cold or an allergy. Hayfever, one of the most common forms, is usually an allergy to pollen.

Symptoms and signs

Itchy sensation of the nose and eyes followed by sneezing, stuffiness, a runny nose and often watery eyes.

Treatment

The vast range of hayfever products can be very confusing but if your main problem is a blocked nose, go for a steroid nasal spray. These need to be used at least twice daily throughout the whole season to get the best results. Cromoglycate sprays are an alternative, but have to be used more frequently (up to four times a day). They tend to be less effective for blocked noses, but may help runny noses. Cromoglycate drops are my choice for itchy eyes. If the these fail to control your symptoms, add a modern non-sedating anti-histamine tablet. If in doubt, ask your pharmacist.

RUBELLA

More commonly known as german measles, this viral infection normally affects children between the ages of six and 12. Rubella vaccine is now given in the MMR vaccine to all babies at about 12 months.

Symptoms and signs

In children the disease is often so mild it can go undetected. Symptoms can include a rash on the face which spreads to the trunk and limbs and usually disappears after a few days. In adolescents or adults headache often precedes the rash and the joints can become painful.

Self help

There is no specific treatment for rubella, and painkillers are usually given, along with bed rest.

HEALTH WARNING

Pregnant women and rubella:

Rubella is a serious risk to the unborn baby if the mother is infected during the first four months of pregnancy. Common abnormalities include deafness, congenital heart disease, mental retardation, cataract and other eye problems. Women planning to start a family should have their immune status checked and anyone not immune should have the vaccination. During pregnancy, it is essential to avoid contact with anyone who might have rubella.

S

SCABIES

Tiny mites that lay their eggs in tunnels in your skin and produce an itchy rash that characteristically affects the hands and feet. They are highly infectious.

Symptoms and signs

The mite's burrows - tiny red tracks - can often be seen on close inspection of the skin, particularly between fingers, on the wrists and in the armpits. These can develop into red, itchy blotches caused by an allergic reaction of the body.

Treatment

The following steps should ensure eradication. Take a warm bath and soap your body all over making sure you scrub fingers and nails. Dry, and apply pesticide lotion - ask your pharmacist - to ALL parts of the body, including the soles of the feet. Wash off after 24 hours and use fresh pillow cases and sheets afterwards. If this fails, repeat using another type of pesticide. It is normal for itching to continue or even get worse for two weeks after treatment. Treat all members of the family at the same time.

SINUSITIS

An inflammation of the membranes lining the sinuses - the air filled cavities in the bones surrounding the nose. Most cases develop as a complication of the common cold or any other respiratory tract infection. Once you have had a few bouts, you become much more susceptible to the problem.

Symptoms and signs

Constant pain over the infected sinus accompanied by a general feeling of heaviness and fullness in the face. Your nose is often full of catarrh.

Treatment

Nasal decongestant sprays can be used, but make sure you follow the instructions and use them for only a few days or they can make the problem worse. If the sinuses are badly infected antibiotics may be necessary. If you suffer recurrent problems you may need to have the infected material drained under local anaesthetic.

SHINGLES

A common but painful condition which affects one in five adults at some point in their lives. Although serious, complete recovery nearly always occurs.You can't catch shingles. Most people get chickenpox as a child and the virus never completely disappears but "hibernates" in the spine, sometimes re-emerging many years later as shingles. It tends to strike during illness or in old age.

Symptoms and signs

Shingles starts with excessive sensitivity and pain normally felt on the surface of the skin where the disease is going to strike. The pain gradually gets worse and a rash breaks out a few days later with little vesicles forming. The rash often creeps around one side of the body, most commonly the chest and upper abdomen. Pain usually disappears with the rash or soon after. Sometimes pain known as postherpetic neuralgia (caused when the virus damages the nerve) persists following the attack.

Treatment

Several anti-viral drugs have been developed which can shorten the bout of shingles. They should be used early in the attack and can reduce the chance of the patient developing post-herpetic neuralgia. In the case of patients who do, there are drug treatments. Failing that, the nerve sometimes has to be blocked with an injection, but this does leave the patient with an area of permanent numbness.

SPRAIN

An injury caused by the overstretching or tearing of a ligament - the tissue which holds the bone ends together at the joints. Sprains are usually caused by a sudden and powerful pull on the ligaments.

Symptoms and signs

Painful swelling, tenderness and bruising around the affected area You may find it hard to move the joint.

Treatment

A cold compress to reduce swelling should be your first action after an injury. Wrap the joint in bandage and rest until swelling subsides. Painkillers will help. Once the pain has disappeared then exercise gently. Badly torn ligaments may need anti-inflammatory drugs, putting in plaster, and, in the most extreme cases, surgical repair.

T

TENNIS ELBOW

A painful condition

caused by inflammation at the point where the forearm muscles attach to the outside of the elbow. It is caused by excessive repetitive movements, or doing a task that involves gripping something tightly, such as a tennis racket.

Treatment

Anti-inflammatory drugs and rest can help, but some cases need a cortisone injection into the tender spot. It is important to identify the cause of the problem to avoid future problems. Changing your tennis grip can work marvels.

TETANUS

A potentially fatal disease, also known as lockjaw, that affects the central nervous system. It is caused by a toxin released by the bug Clostridium tetani, spores of which can be found almost anywhere, but are particularly common in dust and soil. These spores can enter your body through the tiniest cut or scratch. Symptoms and signs

Symptoms can appear within a week of an injury or up to several months later. The head is usually affected first, with the jaw becoming stiff and difficult to open. This then spreads to other muscles in the face and neck.

Sufferers can develop severe chest spasms which can result in suffocation.

Treatment

If tetanus is suspected then seek urgent medical help.

A course of anti-toxin injections will be given, with tranquillisers to control muscle spasms. Even with prompt treatment, half of all cases prove fatal.

Prevention

I advise patients to have booster jabs every 10 years. EVERYONE should keep their tetanus vaccinations up to date.

TONSILITIS

Inflammation of the tonsils largely caused by infection. Young children are most at risk because their tonsils are large and prone to infection.

Symptoms and signs

A sore throat and difficulty in swallowing are common indications. On examination, the throat is visibly inflamed.

Treatment Most tonsils shrink after the age of six and so doctors are reluctant to operate before then, instead relying on antibiotics and painkillers.

U A raw area in the lining of the digestive tract most commonly in the stomach or duodenum. Occasionally, ulcers can bleed and, in rare cases, they burst and may be life-threatening. Ulcers are more common in men, but family history, stress, smoking and alcohol consumption all increase risk.

Symptoms and signs

The pain is generally centred below the rib cage and it travels through to the back. It is often described as burning or gnawing, and may be worse at night.

Diagnosis is normally confirmed by endoscopy - when a tube is passed through the mouth or mouth to the stomach and duodenum - or by taking a barium meal X-ray.

Self-help

Avoid smoking, drinking alcohol, coffee and tea, using aspirin or other non-steroidal, anti- inflammatory drugs. Eat several small meals a day at regular intervals, rather than two or three large ones.

Treatment

Anti-acid drugs available from the chemist without a prescription can be used to neutralise the excess acid, and control the symptoms, but will not heal the ulcer. GPs can prescribe H2 blockers which reduce acid production.

Your GP may undertake a Helicobacter pylori screening test if you have an ulcer or a history of recurrent severe indigestion, or a strong family history of stomach cancer. Helicobacter pylori is a bacteria which can make you more vulnerable to ulcers.

If the test is positive, your GP can prescribe a short course of antibiotic therapy.

V

VARICOSE VEINS

Enlarged and twisted veins lying beneath the skin, usually on the legs. Varicose veins are very common and tend to run in families. Obese people are at high risk as are those who spend a lot of time on their feet, pregnant women and women who have reached the menopause.

Symptoms and signs

The most common sites for varicose veins are on the backs of the calves and insides of the legs. The veins themselves are blue, visibly enlarged, prominent and twisted. Sometimes they can become inflamed, start to bleed, or the problem can lead to swollen legs and ulcers.

Treatment

There are three treatments - wearing elasticated support stockings to ease the swelling and discomfort, injecting the veins to seal them, and removing the veins altogether.

W

WARTS

Contagious growths on the skin or mucus membranes.

All warts are caused by the human papilloma virus, of which there are about 30 known types.

Symptoms and signs

The first sign of a wart is a small horny lump commonly on the hands, head or knees.They can become flattened if they occur on a pressure bearing surface such as the base of the foot - a verruca.

Treatment

About half of all warts disappear after about 6-12 months without treatment. You can treat them yourself, but it is a long-winded affair that involves painting the warts with an acidic substance that slowly dissolves them.

Most disappear within six weeks using this treatment. Wart lotions should never be used on the face or genital area. If treatment fails, see your GP, who can offer a liquid nitrogen treatment which freezes the wart and is normally very effective.

HEALTH QUESTION

Q: Is it true that you can get rid of warts by

rubbing them with potato skins?

A: There are all sorts of weird and wonderful remedies for warts, but I am sorry to say that most of them are a load of nonsense. Warts are caused by a virus and can disappear without trace for no apparent reason. This "magical" disappearance is the reason why some people swear by remedies like rubbing with potatoes, staring at a full moon - and kissing a frog!

WHOOPING COUGH

An extremely contagious bacterial infection of the respiratory system, also known as pertussis, that usually affects children and is of particular danger to young babies. It is mainly caused by the bacteria Bordetella pertussis, which is spread from person to person during coughing. Whooping cough can be prevented by immunisation in infancy in the form of the triple vaccine which also protects against diphtheria and tetanus and is given to children at three, five and nine months of age.

Symptoms and signs

The incubation period is between one to three weeks and the disease lasts up to 10 weeks. The main features are violent coughing to get rid of the decongestion in the lungs, often ending with a characteristic whoop. Young babies are at severe risk as they cannot cough up the mucus in their lungs.

Treatment

Taking antibiotics early on in the infection can shorten the duration of the illness and make the patient less infectious. However, once the severe coughing phase of the illness has started they are not that useful. Other treatments consist of keeping the child warm, feeding them small frequent meals and plenty to drink.

Z

ZZZZZ...SLEEP PROBLEMS

Difficulty sleeping or insomnia is very common, affecting a third of the population, half of whom regard their problem as serious. The most important thing to remember is that insomnia is not a medical condition, it's a symptom -

and as with all symptoms, there is an underlying cause. The cause can be a physical illness (such as pain from arthritis), a psychological problem (such as anxiety), a psychiatric problem (such as depression), a physiological problem (such as late night eating) or a pharmacological problem (such as excess alcohol) - the five Ps as doctors refer to them. The important thing is to discover and correct the cause.

Self-help

There are many things you can do to improve your sleeping habits. Don't nap during the day as this interferes with your sleep patterns. Avoid the following before bedtime: strenuous exercise (apart from sex); a heavy meal; caffeine, nicotine and alcohol. Go to bed only when sleep-tired, and if you don't fall asleep within 20 minutes get up and do something relaxing. Get up at the same time every morning and make sure your bed is comfortable.

Warning

Sleeping pills will simply cover up the cause of the problem. They should be used only to treat transient insomnia (such as jet lag or the stress of a divorce or a bereavement). Treat the cause, NOT the symptom.
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Title Annotation:Features
Author:Porter, Mark
Publication:Sunday Mirror (London, England)
Date:Oct 27, 1996
Words:3929
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