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Wed, 14th September 2016
 

Pain developing around the navel, then gradually moving to the R.I.F., short for right iliac fossa (an anatomical term for the lower right side of the abdomen), feeling off colour, mild fever but often not, maybe some vomiting or constipation are the tell tale early symptoms of appendicitis. Left, it will gradually worsen. Symptoms increase as the organ swells, fills with pus, and if untreated may explode leading to gangrene and peritonitis (inflammation of the entire gut system).

In days of old, people either recovered by nature or simply died. King Edward VII's coronation in 1900 was delayed for a year following the death of his mum Queen Victoria. A makeshift theatre was set up in Buckingham Palace, he underwent surgery and luckily survived.

The appendix is a tiny wormlike appendage which sprouts from the caecum, where small bowel joins the large bowel called the colon. In humans it has no known use, but helps koala bears digest gum leaves and is very long. During the first half of the 20th century, the revolution in eating habits exploded out. Kellogg had introduced corn flakes and other high fibre foods, and Sanitarium kept it going. This massive fibre intake improved bowel regularity and appendicitis has almost vanished.

Often with symptoms as above, surgeons simply did a simple early appendectomy, and patient was back home within a week. Today, all that has changed again as technology races on. Today, a heap of investigations may occur. "Helical CT multi-slice imaging" is often standard and gives a quick accurate diagnosis.

If considered positive, fluids and antibiotics are given, and often give a positive outcome. If not, surgery takes place. The old "open incision" in many centres has been superseded by keyhole surgery (laparoscopy). The patient may be up and back home in a day or two. Today, nobody should die from appendicitis, but some still do, usually due to personal neglect and not visiting their GP. This is unforgivable.

 
CORN CORNER

Q: 

Mum hobbles around all day complaining of her corns. Surely there is simple effective treatment.

A: 

Corns are due to thickening of the skin through surfaces rubbing. Commonest are shoes that are too tight, too short or too narrow. There may be irritating stitching or uneven surfaces inside causing constant irritation. Often the tiny bones of the toes develop knobs at each end, causing lumps or become deformed, allowing abnormal irritation. I think seeing a podiatrist the best starting point. They may quickly identify the cause and offer appropriate steps to minimize this. They can also treat the corns by careful paring. Gross toe abnormalities may require special surgical shoes, an orthopedic intervention. Today, most issues are fixable.

 
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STILNOX

Q: 

I have taken Stilnox to help my sleeping problem, but like many others, discovered I was sleep walking and gorging in the kitchen, with no recall next day.

A: 

Hundreds of similar stories abound. It is a wonderful sleep inducer, but this adverse effect is now quite common, has been widely publicised and could lead to all manner of potential disasters. The manufacturers now openly advise caution, and it is meant for short term only - it comes in packs of 7. Take for minimum time. Both your doctor (prescription only), and chemist will undoubtedly advise of these issues. Final decision is with you. I no longer prescribe it, having taken it for a while and went bad with nocturnal walkabout!

 
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DOG BITES

Q: 

Having been bitten by a dog and left with severe lacerations, I am now terrified of them. But contact is inevitable if you go for a daily walk.

A: 

Many councils make it mandatory for dogs to be kept on leashes at all times when outside the home fences. However, many owners disregard this and let them run amok. All dogs evolved from wolves and their natural food is meat. Never forget this. Maybe vary your walk pattern to avoid known trouble areas. Never confront a dog, don't stare at him, don't throw stones, hit or aggravate, for they are very swift to move and have teeth meant to tear flesh. Ignore the animal, and keep walking, don't run.

 
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WHITE MELANOMAS

Q: 

We constantly are cautioned to report any dark mole to the doctor, specially if it is irregular and enlarging, in the event it may be melanoma. But I understand there are some which are not dark in colour.

A: 

Non pigmented melanomas are the doctors nightmare, and very difficult to detect. I believe it is worthwhile having a skin check by the doctor annually, and if there is any suspicion with any mole, referral to a dermatologist. Intervention is much preferable to waiting if there is any doubt, for they are just as dangerous as the pigmented kind. Again, reduced sun exposure is recommended for all Australians.

 
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COLA DRINKS

Q: 

Will cola drinks rot the teeth?

A: 

I once placed a tooth in a cola bottle for five years. There was no visible erosion. But it's pretty powerful stuff. A motel owner friend uses it to clean baggage marks on unit walls, claiming it is very effective. However, sweetening agents can help build up of plaque which attacks dental enamel. Some also claim it sucks calcium from the bones, leading to premature osteoporosis (bone weakening). What's up with drinking tap water?

 
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This health advice is general in nature. You are advised to seek medical attention from your doctor or health care provider for your own specific symptoms and circumstances.

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