Dr James Le Fanu: 26 April
The Baltic Sea can be pretty cold, but not cold enough to discourage my father, at the age of 80, from plunging in for an invigorating swim. He attributed his hardiness to his school days at Epsom College in the 1930s, with its daily routine of an early-morning dip in the sometimes icy waters of the unheated swimming pool.
This human adaptability to cold is well illustrated by the extraordinary tale of the explorer Henry Robertson ‘Birdie’ Bowers, who in 1911 set off to Antarctica to collect the eggs of the Emperor penguin. Bowers apparently slept soundly in temperatures below -20°C without the eiderdown lining of his fur sleeping bag. Why was he so insensitive to the cold? Every morning, to the fascinated horror of his companions, he would strip naked in the freezing Antarctic air and douse himself with buckets of icy water and slush.
There is more to such tales of human endurance than is readily apparent. The crucial point is that the millions of chemical reactions taking place in the body every minute require the core temperature to remain within very narrow limits at around 37°C. A fluctuation of just 10°C either way can cause death from hypothermia or heat stroke.
The body’s first priority in intense cold is to reduce heat loss by closing down the circulation of warm blood through the capillaries in the skin. The second option is to stoke up the internal temperature by shivering, as repetitive muscular contractions generate heat. This facility of humans to adapt to extremes of temperature is admittedly only temporary. Not even Birdie Bowers could – as do the Emperor penguins, whose eggs he was gathering – stand on a piece of ice for four months without food in winds of 125mph holding a single egg between his toes.
THIS WEEK’S MEDICAL QUERY comes courtesy of a lady from Hampshire, who 10 years ago developed a pain in her left hip, which was particularly bad at night, routinely waking her at two in the morning. The obvious diagnosis of arthritis was excluded with a normal MRI, and accordingly she was treated with a combination of anti-inflammatory pills and a cortisone injection. ‘None of these has done much good,’ she writes, although at least her pain is less severe than in the past.
The probable diagnosis here is inflammation of the site (or bursa) where the muscles insert into the bony part of the upper leg (the greater trochanter), otherwise known as trochanteric bursitis. This should respond to cortisone injections but when, as here, it does not, this raises the possibility of some mimicking condition usually labelled, for obvious reasons, ‘pseudo-trochanteric bursitis’ – where the pain is referred from the nerves of the lower lumbar spine, the spinal joints or ligaments. Here, treatment of the underlying cause is likely to be most effective.
drjames@lady.co.uk
‘I would sit in my office, and by about 10am each day get a slight sore throat, and my voice was affected. This grew worse as the day went on. In the evening at home, the problem would subside, and by morning I was normal again. This went on for a year or more until a friend saw a television programme about ferns, whose spores floating about the room can affect some people. I had a large fern in my office, which, once removed, resulted in an instantaneous cure.’
This human adaptability to cold is well illustrated by the extraordinary tale of the explorer Henry Robertson ‘Birdie’ Bowers, who in 1911 set off to Antarctica to collect the eggs of the Emperor penguin. Bowers apparently slept soundly in temperatures below -20°C without the eiderdown lining of his fur sleeping bag. Why was he so insensitive to the cold? Every morning, to the fascinated horror of his companions, he would strip naked in the freezing Antarctic air and douse himself with buckets of icy water and slush.
There is more to such tales of human endurance than is readily apparent. The crucial point is that the millions of chemical reactions taking place in the body every minute require the core temperature to remain within very narrow limits at around 37°C. A fluctuation of just 10°C either way can cause death from hypothermia or heat stroke.
The body’s first priority in intense cold is to reduce heat loss by closing down the circulation of warm blood through the capillaries in the skin. The second option is to stoke up the internal temperature by shivering, as repetitive muscular contractions generate heat. This facility of humans to adapt to extremes of temperature is admittedly only temporary. Not even Birdie Bowers could – as do the Emperor penguins, whose eggs he was gathering – stand on a piece of ice for four months without food in winds of 125mph holding a single egg between his toes.
THIS WEEK’S MEDICAL QUERY comes courtesy of a lady from Hampshire, who 10 years ago developed a pain in her left hip, which was particularly bad at night, routinely waking her at two in the morning. The obvious diagnosis of arthritis was excluded with a normal MRI, and accordingly she was treated with a combination of anti-inflammatory pills and a cortisone injection. ‘None of these has done much good,’ she writes, although at least her pain is less severe than in the past.
The probable diagnosis here is inflammation of the site (or bursa) where the muscles insert into the bony part of the upper leg (the greater trochanter), otherwise known as trochanteric bursitis. This should respond to cortisone injections but when, as here, it does not, this raises the possibility of some mimicking condition usually labelled, for obvious reasons, ‘pseudo-trochanteric bursitis’ – where the pain is referred from the nerves of the lower lumbar spine, the spinal joints or ligaments. Here, treatment of the underlying cause is likely to be most effective.
drjames@lady.co.uk
Fronds of Fire
The cause of a chronic sore throat can be surprisingly elusive, but if it fluctuates in severity throughout the day, you should consider that you may have developed an allergy – as a reader from Lancashire describes.‘I would sit in my office, and by about 10am each day get a slight sore throat, and my voice was affected. This grew worse as the day went on. In the evening at home, the problem would subside, and by morning I was normal again. This went on for a year or more until a friend saw a television programme about ferns, whose spores floating about the room can affect some people. I had a large fern in my office, which, once removed, resulted in an instantaneous cure.’