Dr James Le Fanu: 5 July
We live for the most part comfortably enough inside our skins – paying scarcely a thought to the near-miraculous properties of this seamless stocking that flexes and curls around the contours of the body. The most impressive of the skin’s many attributes is undoubtedly its reconciliation of the two contradictory properties of being both a robust barrier against the outer world, while being simultaneously – through the sense of touch – exquisitely sensitive to it. Here, as ever, biology trumps anything that human ingenuity can devise.
For all that, the constant discomfort of conditions such as eczema, can profoundly affect a sufferer’s state of mind. ‘My eczema and the struggle to live with it, has shaped my disposition, my feelings and my relationships,’ observes a contributor to the Quarterly Journal Of Medicine: ‘Many of my memories of childhood are of the incessant, futile struggle to resist the itch, and the shame and despair of doing so.’ He notes too how the skin o ers psychological protection for when his parents quarrelled (which they did a great deal), ‘I would itch and scratch yet more’.
To compound it all, the treatment was almost as bad as the condition – with his head and body smothered in pungent coal-tar ointment and his arms encased in cardboard tubes to create a physical impediment against scratching.
Modern treatments, such as steroids, are much less drastic, but eczema is one of the few conditions whose severity is responsive to psychological treatments that boost resistance to stress – that make, one could say, the patient more thick-skinned.
This week’s medical query comes courtesy of a woman from Norfolk, now in her mid-70s, who for most of her life has had mild migraine attacks lasting on average a couple of hours, with headache and visual disturbance. But over the past year, these have become much more frequent – though not particularly debilitating – and may occur once or even twice in 24 hours, often in the middle of the night.
She has been checked out at the local hospital but no speci c explanation has been forthcoming. She would welcome any advice as to what might be responsible. It is di cult to know why these mild migraine attacks should have increased in frequency, but when they occur as often as once or twice a day this clearly warrants some form of preventative treatment.
There are a variety of possibilities, but the simplest would be to start with a low dose of a beta-blocker such as atenolol in anticipation of an attack. It will drastically reduce or even abolish these episodes altogether.
Email drjames@lady.co.uk
For all that, the constant discomfort of conditions such as eczema, can profoundly affect a sufferer’s state of mind. ‘My eczema and the struggle to live with it, has shaped my disposition, my feelings and my relationships,’ observes a contributor to the Quarterly Journal Of Medicine: ‘Many of my memories of childhood are of the incessant, futile struggle to resist the itch, and the shame and despair of doing so.’ He notes too how the skin o ers psychological protection for when his parents quarrelled (which they did a great deal), ‘I would itch and scratch yet more’.
To compound it all, the treatment was almost as bad as the condition – with his head and body smothered in pungent coal-tar ointment and his arms encased in cardboard tubes to create a physical impediment against scratching.
Modern treatments, such as steroids, are much less drastic, but eczema is one of the few conditions whose severity is responsive to psychological treatments that boost resistance to stress – that make, one could say, the patient more thick-skinned.
This week’s medical query comes courtesy of a woman from Norfolk, now in her mid-70s, who for most of her life has had mild migraine attacks lasting on average a couple of hours, with headache and visual disturbance. But over the past year, these have become much more frequent – though not particularly debilitating – and may occur once or even twice in 24 hours, often in the middle of the night.
She has been checked out at the local hospital but no speci c explanation has been forthcoming. She would welcome any advice as to what might be responsible. It is di cult to know why these mild migraine attacks should have increased in frequency, but when they occur as often as once or twice a day this clearly warrants some form of preventative treatment.
There are a variety of possibilities, but the simplest would be to start with a low dose of a beta-blocker such as atenolol in anticipation of an attack. It will drastically reduce or even abolish these episodes altogether.
Email drjames@lady.co.uk