Rude health: Pass the tea bag
Having noticed huge variations in prices and rules governing paracetamol, Maurice Gueret refuses Chinese miracle tea
The nib is dry, so there won't be a third book for the Christmas bookshelves this year. I am working on a new opus on minor ailments and how best to treat them for 2016. With the arrival of so many drugs on supermarket shelves, self-medication without involving a doctor or pharmacist is going to increase big time.
This could be advantageous to patients, but education must be stepped up to match the marketing. Now I was doing some research in the great-grandfather's homestead of Newry recently and saw at first-hand the impressive array of medicines now stocked in its Sainsbury's supermarket. The UK takes retail therapy more literally than we do. One advantage of big-store sales versus pharmacy sales, is that products are out-front and visible. Prices, pack sizes and the all important dosages and ingredients can easily be compared. You just need to know what you are looking for.
Paracetamol is the most commonly used pain reliever in this part of the world. The maximum dose for an adult is eight 500mg tablets a day and use for more than three days is not advised unless instructed by your doctor. Paracetamol overdose is extremely dangerous, as irreversible liver damage and a protracted death may result. In UK supermarkets you can buy four days' supply, but strangely the Irish republic restricts you to a day and a half. In a Dublin supermarket recently, I was refused two packets of twelve paracetamol because of these regulations. The single box of twelve 500mg tablets that I was allowed take home cost me €1.59, or just over 12c a tablet. In Sainsbury's of Newry, customers are allowed purchase two own-brand packets of sixteen paracetamol tablets. Each packet costs just 40c (30p sterling) which meant the cost of a single tablet is 2.5c - one-fifth of the price I was charged in Dublin. Bit painful? Well not as painful as the €8m-plus the HSE spends on 1.3m medical card paracetamol prescriptions each year. Seems like they don't shop in Newry either. Next week I'll tell you how I did with another common painkiller called ibuprofen.
Chinese blend tea
I read that a revolutionary miracle weight-loss tea based on an ancient Chinese blend has arrived in Ireland. It will cleanse and detoxify your body, discourage the formation of fat, support your internal organs, speed up your metabolism, burn fat stored in your system, cause natural miracles, increase your energy levels, reduce bloating and cause you to lose up to 10lb a week. But with 30 tea bags on special offer for €29.95, plus an extra €5.25 for the postage, I think I'll forego the lotus leaves from China. I'll stick with the lads from Cork and treat myself to a few tea bracks instead.
The British Medical Journal reported this summer that hospital autopsies are on the verge of extinction. Just one in every 200 deaths in hospitals now results in a post-mortem examination. Interestingly, the rate in Scotland was about four times higher than that found in England, Wales and Northern Ireland. Huge variations were also found between different hospitals and trusts. Post-mortems are mandatory for cases that involve coroners. It is consent from families in non-coroner cases that is declining. The drop-off perhaps discourages doctors from even bothering to request permission. Post-mortems are the only chance that many medical students have of physically seeing the actual diseased organs they read about. Senior doctors have expressed concern about the impact on the training of future doctors and pathologists. Soon, you may have no priest to bury you and no doctor to find out why you are being buried.
Church hand shaking
On matters religious, James has been in touch about the dangers of shaking hands in church. He was given the impression by a medical person that one of the most likely ways to spread colds and influenza is by shaking hands indiscriminately and he has asked me to discuss. Well James, church attendances are such these days that the dangers must be very much lower than they used to be. Spread of common cold and flu viruses is mainly by airborne droplet, so you are much more likely to contract them from a sneezer or cougher in the rows around you than from a friendly handshake in your own pew. Tummy bugs are, however, a different matter, hence the strict hand-washing advice for anyone with loose bowels. All you can do is pray that active tummy bugs prevent church-going in the first place.
Waiting-room experiences may be no better in private hospitals. One reader has been in some of the swankiest hospitals in the country and is less than impressed. In one clinic, she was well on time for her 11am appointment but four-and-a-half hours later was still perched in what she called her "tiny section" because "you certainly could not call it a room". There was no water, no mention of lunch and no apology for the unseemly delay (275 minutes in the end). A further appointment in a different private hospital was scheduled for 9.30am and didn't take place until 1.20pm. She tells me the cubicle was so small that some patients were standing. There was no water, no grub, no apology and the only magazines to pass the time with were filthy and ancient yokes. She contrasted the amount of money that was extracted from here on each occasion with the level of care and consideration that was meted out to her. Needless to say, they didn't match.
Dr Maurice Gueret is editor of the Irish Medical Directory
Sunday Indo Life Magazine