Thursday 19 April 2018

Observing moles - keep a close eye on pigmented spots and lumps


Moles in medicine are a serious business
Moles in medicine are a serious business

Maurice Gueret

It's important to hire the right kind of mole expert if you have concerns about melanoma, says our expert, who also spots a need for scooter safety school

Mole in a Hole

Moles in medicine are a serious business. You need to keep a close eye on pigmented spots and lumps. Changes should be shown early to the doctor, especially if there is irregular growth, colour changes or bleeding. It's good to have a friend to check lesions in awkward spots, like the back of the leg, neck or ear. If in doubt, let medics check it out. Melanoma is a growing problem in Ireland, with nearly four cases now being diagnosed every week day. It's no laughing matter, but I did spot an amusing anecdote in the letters page to the London Times. A reader's friend was made redundant and decided to set up a service to remove troublesome moles from people's gardens. He advertised 'mole removal' in a local paper and soon had his first customer. The lady was a bit surprised to see him arrive with a shovel and a bucket. The mole was on her face.

Coroner's Case

A very sad case came up in Dublin Coroner's Court recently. It concerned a lady in her mid-60s who suffered an awkward fall at home in Crumlin. Her hip was both broken and dislocated by the tumble and she was unable to move or to summon help. She lived alone, and her son would call frequently to bring her shopping. But it was at least two days before she was found after her fall. She was pronounced dead at the scene. The coroner returned a verdict of accidental death from internal blood loss. It was reported that she lost half-a-litre of blood into the soft tissue around her hip. When you reach a certain age in Ireland everybody is entitled to receive a free bus and train pass. Many pensioners never get to use them. A State-sponsored monitored personal-alarm button for all older folk living alone might just be a better investment. Not everyone carries a mobile phone.

Three Cent a Text

New figures have emerged about patients who don't show up for hospital visits. I mentioned this recently when we discussed how silly it is to remind patients by text of their appointments when they are offered no facility to text back a reply. On calling, the phones are invariably engaged. Last year, there were 135,000 new-patient visits missed, while 345,000 return visits were missed by existing patients. The loss to the Exchequer, we are told, was €25 per visit, or €12m in all. The cost of a text-messaging service that allows responses is about three cent per patient. The more texts you buy, the cheaper it gets. A no-brainer for the HSE, who need to get their texting finger out.

Scooter Hooter

A few years ago, the American Academy of Paediatrics issued a major warning about scooter safety and children. Watching the morning school rush in Dublin, it appears that the cautions have not crossed the Atlantic. They urged close supervision for children under eight, mandatory helmets and no riding alongside moving traffic. This followed a 40pc increase in accidents involving kick scooters, the lightweight wheels that children power with their feet. I am no accident expert, but a quick scoot around Dublin suburbs would suggest that most of our footpaths are extremely dangerous for child scooters. Some of the inclines would suggest fatalities are just waiting to happen. Not to mention obstacles and cars exiting houses on the blind. Helmets and joint pads are a rarity. Supervision by one pram-wielding parent trailing 50 metres behind a flying child is not really optimum. I don't work in a paediatric emergency department these days, but I'd be interested in hearing from those who do.

Golfer's Lumbago

Rory McIIroy's back has been playing up recently. Let's hope he's not heading into the same lumbago ward as Tiger Woods. Our finest golfer returned from honeymoon last month and overdid it on the practice range. He was due to play in his first post-nuptial tournament in the USA, but hit too many practice balls without warming up. He completed all four rounds of the tournament, but needed painkillers, back strapping and physiotherapy to stay on course. Then he flew to Belfast for an MRI scan, saying that he wouldn't know what was going on until he got an image. Little surprise that his image was all clear. Doctors might well differ about whether a solitary stiff back after some marathon golf practice session really necessitates a claustrophobic transatlantic date with a few giant magnets.

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