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Wed, 21st January 2015

I sit here rubbing my foot. The damn thing is itchy. The more I scratch, the more it itches, the harder I rub and the more annoyed I become. Then all of a sudden say "Gee, I am a doctor, what am I doing scratching the top of my foot. I am nuts. I know the more I scratch the more I tear the upper skin lining, the greater chance it will turn red and probably become infected". So, I whip off my sock, apply a cold face flannel, and presently, five minutes later the itch has gone.

Why do I scratch my foot every now and again. Why does anyone scratch any part of the epidermis? Because it irritates, the mechanical rubbing gives temporary relief, but it is short lived - like two seconds and then re-starts.

In most cases the skin is trying to say leave me alone. I am in misery or do something about this. When something is irritating me most symptoms mean something. It is the bodys' inbuilt "alarm system", just as pain also means something is not right.

Skin irritation is often due to an immune response. This causes local blood vessels to dilate, bringing fresh blood. The part often turns red, and often leaves a raised read mark called "wheal". That is why cold applications help, or better, creams containing a small amount of cortisone is also effective as it is anti-inflammatory. Some inherently have dry skin. This also tends to itch. A blood sugar check is suggested, for it may be the first and earliest symptom of diabetes, currently suffered by two million Australians, half as yet undiagnosed. If blood sugar is above 7.0, treatment (usually diet modification) is recommended under your GPs supervision. Occasionally medication is needed.

There are millions of tiny fat or sebaceous glands in the skin, usually attached to a hair follicle. These give the skin its typical moist supple feeling. If they are low in activity or not there, dry skin follows. Try and avoid direct heated air conditioners, excessive washing, avoid harsh alkaline soaps. Use a non alkaline solution or bar. Dab dry with a soft towel.

Place a cup of oatmeal (rolled oats) in a sock, tie the top, and knead the milky stuff into the bath. Lie for a 10-15 minutes soak. It is very soothing. Then again dab the body dry with a soft towel. Do not rub, for this increases surface circulation and aggravates. Many are "allergic" to items they contact, called "contact dermatitis". This includes millions of allergens and chemicals often used in industry and everyday life. Perfumes, soaps, creams, chemicals, aerosols, paints and varnishes head the list. If itch follows their use, either avoid or wear protective gear (eg gloves, long sleeves, etc.)

Often a cool (ending in cold) shower is effective, probably a few times a day, specially in summer. Even some vitamins may cause itch, like large doses of vitamin B3 or nicotinic acid. Many were allergic to the contents of older type medicinal mixtures. Hives are another allergy type reaction. Foods are a common cause, specially in children. Finding the offending items was often difficult. Sometimes it is wheat products, sometimes Berries. Sometimes colourings in beverages, red and yellow being the worst. These can also lead to ADHD in some kids. So they climb around the ceiling as well as have rashes. There are many causes, many identified, others remaining a mystery. But ... try not to scratch. As itch travels along the same nerve pathways as pain, paracetamol may offer relief.



We occasionally hear about marvellous new drugs being developed, but is this really true or a smoke screen?


In general it is all a smoke screen. Nearly all "new drugs" in recent years are “me too” ones. They are simply variations of old ones. The mass market has long since taken over. Pick a disorder that nearly everybody is claimed to suffer, pump out a "drug to cure", and the company is on a sure fire winner. To make certain, the bar is constantly being lowered. Blood pressure of 150/95 was once considered “normal”. Then it dropped, and continues to drop. Many journals are now talking about 120/80 being the baseline above which treatment is suggested. What rot. If everybody reached this figure, they would be fainting in the streets en masse. However, valuable new ones occasionally surface. Such as Herceptin for breast cancer, a very good and effective treatment.

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We continually hear of the "deficits" of the health system, including Medicare. I am an older person, and find the Medicare rebates wonderful. Without this (including generous "upper limits") adequate treatment would be financially impossible. Now I enjoy the best, and am able to pay the tiny balance of each account without difficulty.


Despite its critics, the Australian health system ranks amongst the best in the world. Don't get sick in the US, Hong Kong or Europe. Cheerfully pay the Medicare fee (via taxation), and rejoice that you have access to a marvellous health care system.

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Shock horror! I recently heard on the media that there is an obesity crisis in Australia, and the government is to blame. Then why don't they do something about it


Of course the government is to blame for every known and unknown health crisis, Irresponsible humans play no part. There is a physiological entity called “eating”, meaning in Australia, regularly gorging until one can fit no more into the system. This guarantees overweight ...with the inevitable outcome of diabetes, blood pressure, angina, weak bones, backache, infertility, erectile disorders, and even dropping dead (for the lucky ones...often quick and painless. What better way). Overweight and its dreadful consequences is a personal option, and governments have nothing to do with it.

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My mum turned grey early forties. So did my grandmother. And I am now rapidly greying at the ripe old age of 42. Is there any hope for me?


There is no hope apart from a bottle (hair dye not alcohol). The melanocytes, the pigment containing cells in the hair follicles of the scalp are genetically programmed to cease functioning at a certain age. That is unchangeable. But rejoice, for follicle longevity is common with gray haired persons, meaning you will most likely have a lovely head of hair for many decades to come.

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I had glandular fever when 18, and still notice I feel lethargic specially if I run a fever for a few days or catch a cold.


The EB, Epstein-Barr virus responsible for glandular fever remains in the system for ever. Often if one becomes overtired, overstressed, or suffers another viral or bacterial infection, glands may swell, throat become sore, and fatigue set in for days or even weeks. It will settle down, does not need antibiotics. Drink lots of water, not alcohol of fizz drinks. Take some early nights. You will recover but recurrences are inevitable.

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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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