Health

Wednesday 3 September 2014

Rude Health: Piles of Smiles

From top to bottom, says Maurice Gueret all your suggestions for haemorrhoid-clinic names were hilarious

I did promise to return to the subject of haemorrhoid clinics. Jealous of the wonderful, new, smiley names that dentists are awarding their own premises, I thought it was time that doctors fought back. I invited you to send me some catchy titles, and you didn't disappoint.

Ring of Fire was a good one sent to me by Kathy, who also reminded me that a manufacturer of haemorrhoid cream once used the Johnny Cash song of the same title to promote their wares. The family of the late singer was not best pleased and legal action ensued. Conor also sent me a fine collection, including Piles to Smiles, Haemorr-void, Bottoms Up Prices Down, and Itchin' For Stitchin'. And I liked Anne's suggestions of Pain of Strain and Anus Horribilis. Tom then took up the rear and lowered the tone with The Asoras Clinic.

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Freedom at last, freedom at last. There was saturation coverage of the life of Nelson Mandela, a true hero of our time, before Christmas. Much less attention was given to the manner of his death, which, as an outside medical observer, sounded a very prolonged ordeal. So much for the medical adage that pneumonia can be an old man's best friend. Just days before Mandela's final freedom, it was reported that there was a team of 22 doctors minding him around the clock in his own house. I cannot think of a worse way for a 95-year-old man to go. One good friend told a story of visiting him some weeks before his death, and observing that the great leader could not speak a word because of the tube that was in his throat. Mr Mandela was admitted to hospital with a chest infection last summer, and, somewhere along the way, a decision was made to intubate him, which meant he had a large tube inserted down his windpipe. The tube was attached to a bellows-like machine, which did his breathing for him. The difficulty for a person of this age is that, once you go down this path, it can be difficult to recover the ability to breathe without the machine. Mandela had almost a full six months on life support, even when he went home. None of us know how each will meet our end, but it's never too late to discuss various scenarios with your loved ones. If, by chance or miracle, I do reach 90 or beyond, a few plump pillows, a kindly nurse and a single tweedy doctor on call will do just fine.

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A doctor sent me his entry for the Irish Medical Directory recently. Along with his interests and qualifications, he told me he was a member of the ASCRS. Not having any previous knowledge of this acronym, I took to my computer to do a search. I got two results -- the American Society of Cataract and Refractive Surgery, and the American Society of Colon and Rectal Surgeons. I have it sorted now, but it brought to mind a rather coarse observation about whether he knew his arse from his eyeball. He is rather eminent, so I'm sure that he does!

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A lady in Galway has asked me to write something about cures for warts and skin tags. Not easy to do in a Sunday column, as one man's minor skin blemish might be another man's carcinoma. If your doctor is satisfied that all you have is a minor skin tag, two standard cures were used in my practice days. Sometimes, you could tie it off at the root with a bit of suture thread, which, if done tightly, strangles the blood supply. The theory is, the tag will drop off in good time. The other treatment was freezing them off with liquid nitrogen. I remember meeting fellow Dublin GPs each week in the bowels of Hume Street Hospital and collecting supplies of this gassy substance from a big metal vat. We would all arrive with our thermos flasks at lunchtime, hoping that we didn't make the mistake of mixing it up with lunchtime soup. In the afternoon surgery -- Tuesdays, I think it was -- we'd have patients with skin tags or warts lined up for a bit of medical freezing on cotton-bud sticks, known as cryotherapy. This was a great example of a hospital saving itself a lot of needless referrals by providing the equipment for GPs to do the job themselves. I'm not in daily practice any longer, so I don't know if this service continues anywhere. But what I do know is that the City of Dublin Skin and Cancer Hospital on Hume Street is greatly missed. Access to public dermatology services nationwide continues to be a national disgrace and an oozing sore.

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Just before Christmas, Pat Kenny invited me on to his new morning show at Newstalk to talk about my leabhair nua. We had a great old chat about materia medica, one of many subjects that he is knowledgeable on. I don't know how many decades he has been Ireland's foremost broadcaster, but I could observe that the secrets behind his success are a passion for knowledge, an unrivalled ability to relate this to the common man, and the fact that he still does his homework fastidiously each night. He is the consummate professional broadcaster of our time, and Newstalk pulled off quite a coup in securing him each morning. I always thought that Pat would have made a terrific doctor, but finding a speciality for him would be tough. They say specialists know a lot about very little, and GPs know a little about a lot. But Pat knows an awful lot about everythifng!

Irish Independent

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