Dr James Le Fanu: 29 November
Farmers have a more arduous life than most – certainly as re flected in the unusual skin conditions to which they are uniquely prone. Freezing winds cause frostbite to the ears – otherwise known as farmers’ lug – that become stiff and misshapen with a shiny, purplish-blue discolouration. The combination of wet and cold on the outer thighs from driving the tractor on rainy days, predisposes to panniculitis – painful, itchy red blotches that can take weeks to heal.
Come the summer, the sun’s ultraviolet rays beat down on the face and hands to cause – as no selfrespecting farmer would dream of splashing on suntan lotion – wrinkling of the skin and the indolent blotches known as rodent ulcers.
Farmers catch ringworm from their cattle, contract nail infections from unusual fungi in the soil and are prone to dermatitis from contact with rubber and other chemicals.
All these skin problems are compounded by their reluctance to ‘bother the doctor’, for, being a selfreliant lot, they prefer to treat themselves. ‘They take the attitude “what works for the cows should work for me”,’ observes a consultant dermatologist at Cumberland Royal Infirmary. Gentian violet supplied by the vet for treating skin abrasions in animals comes in handy for treating their own cuts as do, when they are struck down by a chest infection, the antibiotics prescribed for their livestock.
This enthusiasm for selftreatment can, at times, go a bit far – as illustrated by the farmer diagnosed as having pernicious anaemia due to a deficiency of vitamin B12. Rather than go to the local clinic for monthly injections he decided to treat himself with cobalt (part of the vitamin B12 complex) which, he had read, boosts production of the red blood cells. He took it in the form of cobalt fertiliser – diluted 1 gram in 200ml of water. This turned out to be rather more than he needed – 19,000 times the recommended daily intake – and as a result he became pretty ill.
Some might think this a bit foolhardy, but the great virtue of farmers is that they don’t have the same neurotic view about life’s risks as the general population. Doctors might wish there were more like them.
This week’s medical query comes courtesy of a lady from Southwold who earlier this year experienced recurrent episodes of ‘what can only be described as a brain explosion/shock: one sits bolt upright in bed with a vision of a vivid cartoon explosion and the word “bang” in the middle, complete with the noise!’
Her family doctor referred her to the local hospital where she was diagnosed with asthma. But, she writes, ‘I fail to understand how asthma could possibly cause these brain shocks.’
This pattern of symptoms is known, for obvious reasons, as Exploding Head Syndrome. Consultant neurologist Dr JMS Pearce describes this condition of unknown cause as ‘entirely benign… firm reassurance is essential but drug therapy is not warranted’. It may be this lady has asthma as well, but this is not related to the ‘explosions’.
Email drjames@lady.co.uk
Come the summer, the sun’s ultraviolet rays beat down on the face and hands to cause – as no selfrespecting farmer would dream of splashing on suntan lotion – wrinkling of the skin and the indolent blotches known as rodent ulcers.
Farmers catch ringworm from their cattle, contract nail infections from unusual fungi in the soil and are prone to dermatitis from contact with rubber and other chemicals.
All these skin problems are compounded by their reluctance to ‘bother the doctor’, for, being a selfreliant lot, they prefer to treat themselves. ‘They take the attitude “what works for the cows should work for me”,’ observes a consultant dermatologist at Cumberland Royal Infirmary. Gentian violet supplied by the vet for treating skin abrasions in animals comes in handy for treating their own cuts as do, when they are struck down by a chest infection, the antibiotics prescribed for their livestock.
This enthusiasm for selftreatment can, at times, go a bit far – as illustrated by the farmer diagnosed as having pernicious anaemia due to a deficiency of vitamin B12. Rather than go to the local clinic for monthly injections he decided to treat himself with cobalt (part of the vitamin B12 complex) which, he had read, boosts production of the red blood cells. He took it in the form of cobalt fertiliser – diluted 1 gram in 200ml of water. This turned out to be rather more than he needed – 19,000 times the recommended daily intake – and as a result he became pretty ill.
Some might think this a bit foolhardy, but the great virtue of farmers is that they don’t have the same neurotic view about life’s risks as the general population. Doctors might wish there were more like them.
This week’s medical query comes courtesy of a lady from Southwold who earlier this year experienced recurrent episodes of ‘what can only be described as a brain explosion/shock: one sits bolt upright in bed with a vision of a vivid cartoon explosion and the word “bang” in the middle, complete with the noise!’
Her family doctor referred her to the local hospital where she was diagnosed with asthma. But, she writes, ‘I fail to understand how asthma could possibly cause these brain shocks.’
This pattern of symptoms is known, for obvious reasons, as Exploding Head Syndrome. Consultant neurologist Dr JMS Pearce describes this condition of unknown cause as ‘entirely benign… firm reassurance is essential but drug therapy is not warranted’. It may be this lady has asthma as well, but this is not related to the ‘explosions’.
Email drjames@lady.co.uk