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Rude Health: No place to sulk for Minister

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Dr Maurice Gueret

Dr Maurice Gueret

Dr Maurice Gueret

Happy to report that our new health minister reads Rude Health.

Ink had barely dried on my recent good wishes to Dr Varadkar in his en suite office, when @campaignforleo was on Twitter to say that he has no such facility on the top balcony of Hawkins House.

Now, this surprised me, because during the tenure of Matron Harney, a little birdy descended from high to tell me of an extensive boudoir installed under the roof of Dublin's ugliest building. It would appear I was misinformed. I wrongly assumed that there existed a private suite, which, I imagined, included the facility to shower after angry phone calls from the Minister for Public Expenditure. Or perhaps it's just a dressing room, with bright lights and a mirror to hang a spare shirt on. Or maybe just a room whose walls retain memories of Dr Reilly blow-drying Minister White's barnet before the junior man reversed roles for a little beard coiffure.

The word 'boudoir' is interesting. It generally refers to a suite of private rooms for ladies, where they can indulge in dressing up, bathing, or a spot of embroidery. It derives from the French verb bouder, which means to deliberately avoid or stay away from something. If a lady retired too often she might be labelled as sulky, or, as they say in France, boudeureuse. I'm sure Leo isn't one to sulk. By the way Leo, you can follow my own Twitter machine @mauricegueret

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Last week I told you tales of the gland and hormone specialists of modern medicine, the endocrinologists. And I promised to explain another medical boffin called the rheumatologist. The -ologist suffix implies some degree of bookwormery or possession of a body of knowledge. (Quite soon, I expect my own discipline to make GPs more fashionable by pronouncing us to the world as medical omniologists.) Anyhow, the rheum part of rheumatologist comes from the old Greek word for a bodily humour, or flow of a river. Latin then decreed that something which interfered with bodily flow was rheumatic. This covered a multitude of diseases, but as the origins of illness became clearer, rheumatic diseases were ascribed to those caused by problems with creaky joints, bones, muscles and other soft tissues.

Arthritis, in all its guises, would be their major disease, but what we now call connective tissue diseases, like lupus, sarcoidosis or vasculitis, would also attract their attention. Not all arthritis gets referred to rooms of rheumatologists. There are about sixty of them listed in the Irish Medical Directory, just one for every 80,000 in the population. The types of arthritis that particularly interest them are the rare inflammatory ones, that affect multiple joints, like rheumatoid arthritis, ankylosing spondlyitis and painful joints in children.

Severe cases of gout, unresponsive to usual treatments, are often referred too. Rheumatology is a speciality where a large number of exciting novel therapies are now emerging, but their powerful effects need closer monitoring than the old reliables of aspirin, anti-inflammatories and courses of steroids. Like the skin speciality of dermatology, rheumatology would have a reputation as a fairly family-friendly, not to mention bank-friendly, career choice for a young doctor. Not too many emergencies. Few late night calls. And a never-ending conference circuit.

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Split fingers drew one of my biggest postbags of the year and I wish to thank readers who got in touch in search of cures and with suggestions. I should say at the outset that if you have a problem with the skin on your fingertips splitting, run it by your doctor at the next visit. It can happens with Raynaud's disease and other blood-vessel conditions. It can also happen as a symptom of skin diseases like contact dermatitis. And it can happen on account of the tough nature of your job or hobby. Any remedies here are for minor splits that you know the cause of.

A doctor who plays guitar tells me that superglue works great for him. Another lady recommends it too and says it works particularly well on her thumbs. I'm sure this use is what we call in the business 'off-label' and not recommended by manufacturers or health-and-safety folk, so please don't indulge on my behalf.  Superglue can cause no end of unexpected nasty situations in emergency departments and has no place in a family medicine cabinet.

Eamonn wrote to tell me that his mother suffers from split skin on the fingertips and gets great relief from Compeed Heel Crack Plasters. She simply cuts them down to size for the affected area. Unlike superglue, I'm sure your local chemist would stock these. A retired boxer who lives in my favourite village of Skerries remembers a club trainer in his youth who was a dab hand with split skin. He remembers Collodion, a concoction which would fix minor cuts during a fight by forming a temporary skin over the affected area. I think this stuff was also used behind the scenes in theatres to simulate wrinkles in young actors and actresses! It's a fairly toxic and flammable solution with both alcohol and acetone that was extensively used in photography. Stick with the heel plasters, and I'll have more of your cracked remedies next week.

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Just a few medical malapropisms to finish up with. A patient in a northside Dublin hospital waiting for major surgery told her family that she was being moved straight into DCU for a few days following her operation. ICU must have been full. Probably with the patient who told his GP that his operation for an abominable abnormalism (abdominal aneurysm) had gone very well.

Dr Maurice Gueret is editor of the 'Irish Medical Directory'

drmauricegueret.com

Sunday Independent