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Well Being; Watch out for the; TELLY-ACHE!

The new telly series Out of Hours is proving as popular as most medical sagas. But maybe it should carry a health warning...

In one episode alone, the night-call docs dealt with a near-fatal road crash, a nearly-missed meningitis case and a murder!

Sensitive souls might get the impression that this is a typical few hours in their district.

And one storyline may have led them to wonder whether their real-life docs can tell the difference between a belly ache caused by a simple reaction to drug treatment and a deeply serious condition that demands hospital treatment immediately.

At least the show has highlighted the dilemma which doctors face over patients who complain of stomach ache. So let me share a few of the facts with you - which may stop you getting a headache if you worry about what you see on telly.

Everyone gets indigestion from time to time - usually due to eating or drinking too much. Most of us recognise the symptoms and take the usual medicines. We all have an antacid that we like best, that we are used to and we know will help.

We only panic and call the GP if the pain is different, doesn't go away with medicines, is a lot worse than usual, is in a different part of the abdomen or doesn't seem connected with anything we have eaten.

The first priority is to find exactly where the pain is.

Is it above, below or around the navel? Above it, we are looking at stomach and duodenal problems. Below, it may be large bowel and bladder problems.

Around the navel, we could be looking at an early appendicitis.

We also divide the abdomen into right and left halves. Pain in the upper right quarter tends to indicate gall bladder or liver problems. In the lower right, appendicitis or a right-sided hernia are possibilities.

Upper left could be gas in the large bowel or a swollen spleen.

Lower left, and we are looking at diverticular disease, irritable bowel or simply constipation.

Central pain deep in the bottom of the abdomen is usually due to an inflamed or over-full bladder. Pain that passes from the back, round the side of the abdomen into the groin suggests a stone passing from a kidney into the bladder.

Just pointing to where the pain is will give your doc several clues. Then the nature of the pain itself adds more information.

Does it come and go (suggesting colic - cramp of the bowel muscles)? Or is it there all the time, suggesting inflammation? Do you feel terrible/sick/drained/exhausted with it or do you feel otherwise reasonably well?

The answers will give your doctor an idea of whether or not it is an emergency.

Only then will he or she feel the abdomen, gently but firmly. I prefer to start as far away from the pain as possible and gradually approach it. The "feel" of the abdomen is crucial... the muscles may be soft and pliable or hard and resistant.

Sometimes, firm muscles may only indicate the patient's nervousness but that is taken into account - and we use devices to relax them if we can!

If we can't, then we may be dealing with an underlying inflammation, like peritonitis, due to appendicitis or a perforated ulcer. As for exotic illnesses (acute pancreatitis and dissecting aneurysm) to which an episode of Out of Hours referred, patients suffering these would be very obviously ill - and their docs would send them directly to hospital.

These illnesses raise the pulse rate, lower the blood pressure and induce pain much more severe than routine indigestion or stomach irritation.

So don't worry, folks...

Even if the TV doctors look baffled and make mistakes from time to time, real-life ones DO have training - and we usually get things right!

Another popular telly programme, Crimewatch, always warns viewers not to worry that villainy will take over all their lives.

Illnesses portrayed on Out of Hours can be alarming, too.

But they are very rare - and fear of them shouldn't stop you sleeping at night!

News: ECZEMA sufferers have mixed views on sun and summertime. Some find their condition gets worse, others better.

They may need to use more moisturisers, avoid salt water and sand and be careful to wash off swimming pool chlorine.

Some sunscreens actually irritate eczema, so look at the ingredients carefully before choosing one. You may even try a small patch test before buying.

The National Eczema Society at 163 Eversholt Street, London NW1 1BU have a great fact sheet for sufferers.

WEARING high-heeled shoes all the time may increase your chances of getting arthritis in the knees, researchers in America have warned.

It appears that high heels increase stress on the inner side of the knee joint, where arthritis usually starts.

If you must wear high heels, it's best to slip them off at every opportunity - and keep them only for special occasions. This will help avoid lots of foot problems as well.

PORRIDGE, that old Scots stand-by for breakfast, has finally been proven to be good for you!

According to American John Kirwan, women could exercise on a stationary bicycle for 15 minutes longer after an oatmeal breakfast than after eating a modern sweetened cereal with less fibre.

It's all to do with the relatively slow release of energy from porridge...

The faster release from sugar-laden cereals makes people sleepier afterwards.

So porridge is a wise start to the day!

AFTER a bad bout of 'flu recently, I feel very tired. What can I take as a tonic?

THERE'S been no 'flu around for several months, so you may have had another type of infection which has not yet cleared. See your doctor rather than relying on a "tonic".

I'M a fit thirty-something male who runs 15 miles a week and has good health. But I can feel my heart thumping even when resting. I have low blood pressure and get very nervous.

SOME people feel their heart beating naturally. Make sure you leave two days a week WITHOUT exercise to let your muscles rest. And don't worry about your health.

I'M a woman in my 50s and I suffer itching all over my body. Creams and tablets haven't helped.

ITCHING can be a sign of internal problems, like a liver complaint. You may need blood tests - so see your doc.

SINCE I was 17, five years ago, my back has been cracking when I stretch or stay in one position for a while. Does this mean I could develop arthritis later? Should I see a chiropractor?

NO. Many people have necks and backs that creak and crackle when they move and there is no relationship with any disease, including arthritis. This is caused by slight irregularities in shapes of joints and bones and won't get worse.
COPYRIGHT 1998 Scottish Daily Record & Sunday
No portion of this article can be reproduced without the express written permission from the copyright holder.
Copyright 1998 Gale, Cengage Learning. All rights reserved.

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Title Annotation:Features
Author:Smith, Tom
Publication:Sunday Mail (Glasgow, Scotland)
Date:May 31, 1998
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