Medical advice from Doc Wright

Australia's #1 media medic, as seen on InFocus.

2 November 2009

Reader's questions

"Professional patients"

I recently received an email with a question that intrigued me.

"Dear Dr W," it started "I'm worried about my parents who are now in their eighties. They live in their own house, care for themselves, make few demands and still drive the car. However, they seem to have lost touch with reality. Once, they had a large circle of friends and were very active. However, as the friends gradually die off, things are changing.

"Now, their entire life is 'their health'. At least five times a week (every week) they visit the doctor, undergo some sort of intervention or the nurse calls to address 'something'. If I ever phone them (or vice versa), the only discussion is their illnesses, first his, then hers, or vice versa.

"I am now wondering if this has become an obsession, which may be treatable as an independent issue. They must be radioactive for the volume of x-rays and imaging they've had and are probably drained of blood from the number of tests occurring each week or two.

"As this is all on the pension and costs them nothing, I would estimate they have probably cost the government at least $2 million. Surgical operations, cardiac surgery, hospital care and ambulance calls. I love them dearly, but wonder what the future holds."

The email was simply signed "Worried Daughter".

This was my reply:

"Your parents are now 'PP'. That means 'Professional Patients'. Once the syndrome kicks in, it is forever. Doctors call it 'getting on the medical mercy-go-round'.

"It becomes all encompassing. There is no other reason for living and the more they strive to live longer, the more tests-consultations-interventions-pills-operations this involves. It is well known that about 80 per cent of national health resources are gobbled up on those last five years of life.

"The doctorts are painted into a corner. They must appear to do all possible to prolong life and health, at any cost. The cost, of course, is public tax. I am sure your parents see it the same way. They have probably already paid all their bills several times over during their working life which was probably very productive. Or at least in their minds.

"Simply give support and encouragement. It is pointless suggesting they 'ease down'. They will not and do not want to. Listen attentively, just as they listened to your babble when a child. Time will ultimately solve the issue, as 'The End' flashes up on the screen. And all you will then have are memories. Chances are high you will become a PP in time for this is a genetically inherited 'disease'".

Readers' questions

My young son has developed nasty skin sores, probably from his seat-mate at school. What should I do?

This is probably impetigo, a staphylococcal infection commonly picked up from others at school or via infected gear. Bathe off scabs with warm salty water or a very weak (pink only) condys solution. Apply tea tree oil and cover. Antibiotic creams or oral medication are often prescribed. Most heal uneventfully..

Does tetanus still occur in Australia?

Yes, and it is a totally preventable immunisation with DTP (diphtheria, tetanus, pertussis) in infancy, followed by updates which give almost 100% protection. Tetanus still kills many each year especially in developing countries. This occurs mainly via an infected umbilical cord stump following birth. Some cultures still apply manure, which is the richest supply of tetanus spores available..

I have been taking diuretics for 30 years for my blood pressure, which is under good control. When on a vacation, I ran out and therefore visited a local GP. He was horrified at the "ancient pills" I was taking and ordered "whizz bang" new ones. I have never felt worse. Why?

Diuretics first appeared in 1955 to eliminate fluid from the system in heart disease, replacing huge uncomfortable injections called Mersalyl. Then it was discovered they reduced elevated blood pressure. Many have been on them for decades, with their blood pressure under good control. Currently, they are again in favour, along with the also old time "beta blockers". Many patients simply continue with medication which to them is effective.

Are berries a good source of nutrition?

They certainly are. There are many types of berries, with various colours from black to bright red, orange and most colours of the rainbow. They are a rich source of vitamin C, various other vitamins, minerals and fruit sugar called fructose.

Doc Wright is Dr John F Knight AM, a general practitioner, writer and broadcaster who lives Sydney, New South Wales.

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