Curing Tiger Woods
Tiger Woods isn't the first American to have his recovery delayed by chaotic medication management, writes our GP, as he comes in for a slice
The rules of golf are very strict. You are allowed to carry 14 clubs in the bag. Carry one more, and you are immediately disqualified. They need something similar for medicines, too. Tiger Woods is having a bad time of it. He was found asleep in his car a couple of months ago at three in the morning. He hadn't parked it too well. His speech was a bit slurred, so the Palm Beach County Sheriff took him in for his own safety, and for a few tests. The results were published over the summer. There was no booze in Tiger's body fluids, but a strange cocktail of drugs emerged. There were two narcotic painkillers, one derived from morphine and the other from codeine. There was the anxiety drug we know best as Xanax, and a familiar sleeping tablet called Zolpidem. The lab also found a chemical derivative of medical marijuana, something that's now quite legal in the state of Florida. Quite a potent armoury of medicines on their own, but, taken together, they constitute a proper spice bag of potentially dangerous interactions. Tiger apologised, and did the usual celebrity thing, checking into a private clinic. He had been treating his own back pain and insomnia, and promised to seek professional lessons about managing his medicines. I'm available for a quid pro quo. If you can straighten my daylight drive, I'll straighten out your nocturnal driving.
Doctor at Sea
Speaking of sleepiness, the death of an anaesthetist rarely makes international headlines. But the trend was bucked in August when the passing of one such gas man, Dr Gordon Ostlere, was announced. His better known nom de plume was Richard Gordon, author of Doctor in the House, Doctor at Sea and myriad other health-related popular fictions. His books, based on a fictional London hospital known as St Swithins, became popular films, with James Robertson Justice taking the arrogant part of God-like surgeon Sir Lancelot Spratt. Dr Ostlere started writing during a freight trip to Australia - he was employed as the ship's doctor. Nobody got ill on the trip, so he borrowed the purser's typewriter and started making notes on all the funny stories recalled from his hospital days. Eamonn Andrews surprised the doctor in 1974, accosting him with the big red book, saying, "This is your life". Doctor Ostlere replied with that rarely used medical term, "Oh balls", and ran from the studio. His reticence was explained by that favoured medical excuse of all anaesthetists - pathological shyness. But his wife, also a gas-canister doctor, said the show must go on, and prevailed upon him to go ahead with Mr Andrews the following day. That was his life.
The British Medical Journal had a nice article recently detailing some of the strangest 999 calls received by the National Health Service. One caller used the emergency number to ask if the green part of a potato was poisonous (yes, it can be) while another asked what they should do if a wedding ring ever became stuck on their finger (apply copious amounts of soap, oil or butter). But my favourite one was from the lady who had lost her TV remote control and couldn't reduce the TV volume (no cure for that). The serious part of the article focused on plans to reclassify all ambulance calls in Britain. In future, they will be classified as: life-threatening (cardiac arrest; anaphylactic allergy; choking); emergency (stroke; chest pains; short of breath); urgent (having a baby); and less urgent (diarrhoea or vomiting). It's all to do with ambulance waiting times, and the idea is that life-threatening episodes (where a person's breathing has stopped or is threatened) get priority and receive a new seven-minute response time. The downside is that anything other than an immediate threat to life may have to wait that bit longer.
Short of breath
The gym at one Dublin university has a big sign up cautioning new visitors to "ensure your health is sound" by having a medical check. Perhaps. But if this advice is anything more than a legal tick box, then the gym should really provide such a screening service in-house. A heart assessment while running on a treadmill can impart very useful information. They go on to list symptoms that should cause you to stop exercising immediately, like pain and faintness. Shortness of breath is another. Now if I had a penny for every time I heard doctors say that exercise without shortness of breath isn't exercise at all...
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