Heal your heels: Dr Gueret confronts his sore feet
As he confronts his sore feet, Dr Maurice Gueret won't be seeking a cure from the breath of a posthumous child
There are a number of medical problems that can beset the heel of your foot. It's an important weight-bearing junction that receives little attention, until the pain starts.
The worst injury is probably to the Achilles, the rope-like tendon at the back of the heel, which can inflame, tear or even rupture. Treatment depends on severity but may include rest, painkillers, physiotherapy and a plaster cast or surgery for severe cases. Another painful condition is a hard spur in the main bone of the heel, the calcaneus. The bone develops an outgrowth like a small rhinoceros horn and the foot can be extremely painful to walk on.
This summer, I developed quite unmerciful heel pain, and with the help of a consultant in emergency medicine at a barbecue (I always go to the top), a bad case of plantar fasciitis was diagnosed. Now this is the most common of the three heel ailments I have described this week. It's particularly common when your weight is up and your level of physical activity is down. Perhaps this fact, coupled with lime-flavoured Doritos, explains why my own ailment flared up during the World Cup. It has been a difficult ailment to walk off. Foot flexing exercises have helped, but the real relief came when I limped up to the chemist for a pair of orthotic heel lifts. These set me back just under €30, but were worth their weight in gold. Daily pain is now down to once a week and the dog-walking regime has resumed. As the girth of our nation widens, doctors will be hearing an awful lot more about sore feet.
Irish medicine suffered a great loss this summer with the death of Mr Leonardo Antonio Vella, once the best-known casualty consultant in the country. Known better as Leo, he was, for many years, the head of the accident and emergency department at Beaumont Hospital. Indeed, it has been said that Leo Vella invented the speciality of A&E in Ireland. A superb manager who was equally well qualified in both medicine and surgery, it was he who devised the major-disaster plan for Dublin. Twice in his career it was called upon - for the Stardust-nightclub fire and the city-centre bombings in the 1970s. Professor Barry O'Donnell's book Irish Surgeons and Surgery in the Twentieth Century records Leo as having the largest eyebrows in Ireland. He was born in Malta, and, like so many of our best foreign-born doctors, came here in the 1950s to train at the Royal College of Surgeons. Professor O'Donnell recorded in his book that medical specialties often take their character from the first practitioners in the field, and that emergency medicine was indeed very lucky to have Leo Vella. May he rest in peace.
Professors in medical school once gave us a list of 300 things that increase your risk of coronary heart disease. It rounded up all the usual suspects - smoking, high blood pressure, obesity and high cholesterol. But making up the numbers were others such as snoring, not eating mackerel, being poor in a rich world, scrupulous appointment-keeping, not taking siestas and speaking English as a mother tongue. The lesson we learned that day was that altering risk factors may do little good and may, in fact, do some harm. The British Medical Journal carried an editorial and research paper in June suggesting that general health checks don't work, and that though counter-intuitive, it may be time to let them go. This follows publication of a Danish trial showing that screening for risk factors and giving lifestyle counselling has no effect on reducing heart disease. In Denmark, where patients with serious heart complaints already have to wait six months for assessment, the health minister has taken the results on board and abandoned general health-check programmes. Back home, our Government discusses Garth Brooks at Cabinet and still idly promises to screen everyone for everything.
A reader tells me that his mother has been into the chemist asking for a 1960s progressive rock group. Her husband was prescribed an angina medicine called Procoralan, but she has been asking her pharmacist about his Procol Harum. We are unsure if she turned a Whiter Shade of Pale, or red, when she learned of her mistake. Another reader tells me of an unfortunate neighbour who suffered a delightful malapropism when he announced that his son had to have an operation in hospital for an undescended textile!
I hear of some extraordinary cures in this column. By relating them to you, please don't assume that I approve, condone or believe in any of them. I usually don't. But they are part of our history and deserve to be recorded. A reader who once lived in Rathcoole in west Dublin tells me about the breath of a posthumous child and how it cured thrush. (A posthumous child is one born after the death of either parent.) Her first child had oral thrush and she tells me that every fabric in the house was stained with gentian violet to cure it. But every time she stopped, there was still thrush. Then she heard of a local lady, a posthumous child, whose name I won't mention. She came for three evenings, said a prayer and blew into the child's mouth each time. The thrush disappeared. My informant tells me this was no isolated cure. On another occasion, another of her children had oral thrush and she asked a lady who just happened to be a posthumous child without a healing ministry to blow into the baby's mouth. Without prayer, and with just one visit and not three, she tells me it worked.
Dr Maurice Gueret is Editor of the Irish Medical Directory.