Skin Cancer: its a 365 day challenge

Tweet Skin cancer is the commonest preventable cancer here in Australia. One of the most obvious causes is exposure to Ultraviolet light, and the commonest cause of that is the sun. One simple analogy is to equate your skin to a balloon: you can only put so much "in" before a "catastrophe" occurs! In the case of the balloon, it bursts: in the case of the skin, the DNA of your skin cells is damaged and the chance of a cancer developing increases.

There are three common types of skin cancer:

• Basal Cell
• Squamous Cell
• Melanoma

There are others, but they are considered rare eg Merkle cells tumours and lymphoma. Check out the link from Dermis online if you really want to see the nasty end result of too much sun exposure:

http://www.dermis.net/dermisroot/en/18406/diagnose.htm

Prevention:

Don't put too much sun into your skin!! Reduce your exposure, and definitely reduce your childs exposure to UV radiation from a very early age:

• Avoid the sun during the middle of the day: from 10am to 4 pm
• Wear sunscreen year-round: wide brimmed hats and long sleeved garments
• Be aware of sun-sensitizing medications. Some common prescription and over-the-counter drugs — including antibiotics; certain cholesterol, high blood pressure and diabetes medications; and non-steroidal anti-inflammatory drugs — can make your skin more sensitive to sunlight. Ask your doctor or pharmacist about the side effects of any medications you take
• Check your skin regularly

Treatment:

This varies from creams, to freezing, to "shaving", to excision, lasers and radiation: each cancer is slightly different and you need an expert to asses and organize appropriate treatment: and they are much easier to treat IF you get an early opinion! Cancer doesn't go away just because you'd like it to!

Food Allergies

Tweet According to the Australian Society of Clinical Immunology and Allergy, Food Allergies affect about 5% of children and about 1% of adults.  Food allergy involves a reaction of the body's immune system to a  protein in the food consumed and is distinct from food intolerance where there is no immune response. Currently there is no "cure" for food allergy, although thankfully, most children seem to "grow out of it".

Symptoms: there is a wide spectrum of response to food allergy, from the very mild itching of lips to a full blown, life-threatening anaphylactic shock. Here are some of the more common signs of the allergic response

• Tingling lips or itching in the mouth
• Red itchy blotches or hives with itching or eczema
• Swelling of the lips, face, tongue and throat.
• Wheezing, stuffed nose or difficulty breathing
• Abdominal pain, diorrhea, nausea or vomiting

The most serious form of allergic response is Anaphylaxis and requires urgent specialist attention

• Swelling of the lips, tongue and throat
• Difficulty breathing due to severe narrowing of the airways
• Collapse
• Rapid heart beat and low blood pressure

Causes: The problem underlying food allergies is that your body has recognized a sequence of protein in your diet, and decided that it's bad for you; and so it primes the immune system to be "on the lookout" for it the next time it appears. When it does re-enter your body in food, then the immune system responds by flooding the system with histamine and other chemicals in the mistaken belief that it's helping you! So once your system has been primed, even a tiny trace of the protein can trigger a massive response. Here are some of the more common trigger foods:

• Shellfish, such as prawns, lobster and crab
• Peanuts
• Tree nuts eg walnuts
• Fish
• Eggs

In children, you can add Milk, Wheat and Eggs to that list.

Also, for some people, exercise can trigger a food allergy response so it's best to avoid eating before exercise for those with a known food allergy. Finally, those people with hay fever may find that in the hay fever "season" their food allergies are worse as there appears to be a crossed over effect with pollen and the triggering food proteins.

Diagnosis: There is no definitive diagnostic test for food allergies, but a comprehensive history backed up with appropriate testing - skin patch testing and blood tests - can lead to a pretty definite diagnosis.

Treatment: For milder cases, these can be managed by simple over the counter Anti-Histamine medications. For more serious episodes, then medical advice must be followed and patients will need to be trained how to use an Adrenaline containing, self-injecting syringe, and to carry it at all times.

Common Sense:

As my mother used to say -never trust anyone - always read the labels, even if you've had a similar food before, read the label again, as contents can and do change.

If in doubt, don't eat it: it's much safer.

For children: parents do need to be vigilant and tell family, friends and schools that their child has a food allergy and never take a risk that someone will be as careful as you in caring for your child's health.

The elephant in the room: humans didn't invent social networks!

Tweet A few quotes from BMC Ecology caused me to smile today, and made me realize that we humans may think we're smart with our internet connections and Social Network pages, but but whilst we need our address books and iphones, an elephant never forgets!

First quote:

"....while Asian elephants (Elephas maximus) in Sri Lanka may change their day to day associations they maintain a larger, stable, network of friends from which they pick their companions."

And then there's this:

"...Social strategies were also variable, with some elephants always being seen in each other's company while others were 'social butterflies' who frequently changed companions."

Or this:

"Elephants are able to track one another over large distances by calling to each other and using their sense of smell (it's a primitive version of Skype). So the 'herd' of elephants one sees at any given time is often only a fragment of a much larger social group. Our work shows that they are able recognize their friends and renew these bonds even after being apart for a long time (think Facebook after having a manicure)."

So pack your trunk and head for the jungle!

Shingles: an update

Tweet Many years ago I heard Herpes Zoster - more commonly known as Shingles - described as "A belt of roses from hell", and it goes someway to describing the awful pain that shingles can cause. Herpes Zoster is the very same virus that causes chicken pox in young people. The natural history of the disease is that the child gets chicken pox, recovers and develops an immunity to the virus. The virus, meantime, lurks in for decades in the sensory cells of the spinal cord, unable to leave because of the circulating immune cells that are primed to kill it should it try to leave. However, as we get older, our "cell mediated immunity" declines, and at some point it may dip low enough to allow the virus to leave the sensory cells that it has inhabited and travel down the nerve attached to those cells, causing the classic rash eruption in the area of skin supplied by that particular nerve.

So what do we know about Shingles?

• It is an illness of older age: prevalence increases over the age of 60: the estimated lifetime risk of shingles is 20%-30%.
• Contrary to popular belief you can get it more than once: in fact the recurrence rate is about 6%.
• Shingles is preventable. There is a vaccination for Herpes Zoster that not only reduces the risks of developing shingles, but will also reduce the impact of Post Herpetic Neuralgia - the terrible pain that can linger for many months after the rash has abated. 
• The risk for clinically significant pain persisting for longer than 90 days is 14% in people with Zoster, aged 60 years and older.
• Prevention is far more efficient and effective than trying to relieve Shingles. The powerful medications used in the attempt to alleviate the pain and distress of Shingles also can have powerful and unwanted side-effects too.
• Vaccination is recommended for all non immunocompromized people over the age of 60, subject to appropriate advice from their treating physician.

Nails: more than just "Manies and Pedies"

Tweet When I was a medical student, we studied for two years in the basic sciences before ever setting foot on the "wards": needless to say, when we first went into the hospital - following on after the Consultant like a flock of white goslings - we tried to soak up everything we could. One of the first mysteries presented to me was the habit of every senior Doctor to pick up the patients hand and stare at it for a few seconds, before even looking at the patients notes. This happened even if the patient was a heart patient, had lung problems, was missing a leg or unconscious, was 8 months or 88 years old: every last patient examination started with the hand.

Well, the hand can tell you a lot about what may be wrong, or right, with a patient: and even the nails can provide clues to the the individuals health, and not just about their social status! Here are some of the things that Doctors look for:

Nail Clubbing-1

Clubbing: about 80% of cases occur with heart and lung diseases.

Pitting of the nails - Psoriasis -2

Psoriasis: This is a common skin condition but will often affect the nails: psoriasis can vary from the mild form (as in the illustration) with simple pitting of the nails; to severe destruction of the nails with thick layers of psoriatic skin building up underneath the nail bed, leading to gross nail deformities. Psoriasis can also lead to a form of arthritis.

Fungal fingernails -3

Infections:

• Fungal infections are more common on the toenails, but can be found in the fingernails, especially in Diabetics and those on steroids for various diseases. 
• Bacterial infections are more common in fingernails due to trauma or biting of the nails. 
• Viral infections may occur (commonly called a Whitlow, although Orf is another viral nail infection, a disease found in sheep and goats which can be transmitted to humans), and like bacterial infections, tend to happen around the nail and are often very painful.

Cyanosis of the nails

Cyanosis: this is a bluish discoloration of the nails and suggest low levels of oxygen in the blood: a common cause for this is lung disease. In a hospital setting this can be rapidly confirmed by blood gas analysis.

These are just some of the nail manifestations of what may be a widespread clinical problem: the list includes white nails, brittle nails, ridged nails and in many young people, bitten nails: but then, not everything that looks a bit ugly need be a cause for concern.


1 -stanford25.wordpress.com
2- http://psoriasistreat.org/images/pitting.jpg
3 -http://www.toenail-fungus-treatments.com/fungus/nail-fungus.jpg
4 -http://pics.hpathy.com/traub-nov07-cyanosis.jpg

Stopping that itch!

Tweet Ever had an itch that drives you mad? Well, you're definitely not alone with over 200,000 adult Australians self reporting that they have dermatitis, and the rate in children being even higher: in the US the rates are 17 percent of children and about six percent of adults!

Dermatitis, or eczema, is a skin condition that has irritated humans ever since we became mobile and wore any sort of clothes or jewelery, or started to live in huts or houses. But we still don't know what causes it: we have lots of ideas on how to treat it - steroids by mouth and definitely on the skin, plus plenty of moisturizer and the sage words such as, "Avoid contact with what is irritating you", which, as you can imagine, is not very successful with young children who love to play in sandpits and run around on the grass!

But scientists are making tiny steps of progress. Up until recently, the cornerstone of our understanding was that with Dermatitis, there was a failure of the Dermis - the outer layer of the skin - to function correctly, thus allowing pollens and pollutants to get through the body's defenses and cause inflammation and irritation. But it may be that there is a second layer of defense that is also at fault, and in conjunction with a defective dermis, allows the cascade of problems that is dermatitis, to start. This second layer of defense is known as the Tight Junctions, and it's these junctions that hold the cells together. According to Lisa Beck, M.D., lead study author and associate professor in the Department of Dermatology at the University of Rochester Medical Center. "Our findings challenge the belief that the top layer of the skin or stratum corneum is the sole barrier structure: It suggests that both the stratum corneum and tight junctions need to be defective to jumpstart the disease."They've even discovered the protein that is responsible for these Tight Junctions, so the promise of a new line of treatment for Dermatitis is becoming tantalizingly close.

Meanwhile, for those with contact dermatitis caused by Nickel - a surprisingly common allergy as Nickel is found in much personal jewelry - there is hope from the Nano-Tech experts. Scientists at Brigham and Women's Hospital  report a new approach to preventing the common skin allergy by using Nano-particles of Sodium to form a barrier, and to act as a sort of chemical sponge to soak up the nickle atoms released from the offending jewelry. The good news is that the particles they used were of a size that cannot be absorbed into the body: "All results suggest that nanoparticles can effectively prevent the penetration of nickel into the skin, and may therefore abrogate nickel-induced contact dermatitis," the team concluded.

Here's to an itch free future!

Cigarettes, unborn children and heart disease: the link.

Tweet For many years, scientists have known about the phenomenon known as biological imprinting: the classic example is in geese. When the young gosling hatches from its shell it thinks that the first thing it sees must be its mother. So the canny owner of a flock of geese makes sure that when the goslings hatch, he/she is the first thing they see, so that when it comes to getting them to follow you wherever they may go - even if it's to market - then they will follow the human "mother" and not the feathered version.

Now there is an update on biological imprinting as it pertains to health: and it concerns the impact it can have on the unborn infant later in life. "We have found distinct links between cigarette smoking or even using nicotine patches or gum and the long-term harm for the child," says Dr. DaLiao Xiao, a scientist who works at the Loma Linda University School of Medicine in California.

Naturally, being researchers, they have done their initial research on rats, and what they found is that exposure of the unborn rats to nicotine - in whatever form it may be, either through cigarettes or patches - resulted in raised blood pressure, or Hypertension. Nicotine appears to release a chemical that has a direct and permanent effect that alters the normal behaviour of the blood vessel. "This faulty programming is then carried throughout the individual's life and may lead to high blood pressure in adults".

If these findings are confirmed in humans, then this is something that will be beyond the ability of the sufferer to counteract by lifestyle changes. The only way to prevent this will be by both parents making sure that their unborn child is not exposed to nicotine in any shape or form.

Same old, same old....

Tweet When it comes to health it seems that we cannot escope the fact that so many of our helath problems can be improved by three things:

• Not smoking
• Being physically active
• Eating good quality foods in the right quantities

Perhaps if we could put these messages to music: or make an "edgy" film about it: even rearrange the stars in the night sky so that they spell out the same message, but we have to do something that will help reduce heart disease, cancers and now the latest disease that has been found to be "modifiable" by these simple lifestyle changes, Alzheimers Disease.


Over half of all Alzheimer's disease cases could potentially be prevented through such changes, according to a study led by Deborah Barnes, PhD, a mental health researcher at the San Francisco VA Medical Center. They also included in this group, chronic health problems such as depression, mid-life hypertension, diabetes and mid-life obesity, and it was also noted that the other group that is at higher risk are those with a lower standard of education.

So many of these problems do have a solution, or at least established treatment programs, which if used appropriately would help alleviate the terrible disease that is Alzheimers Disease. According to the Australian Bureau of Statistics, here in Australia, "Deaths due to dementia and Alzheimer's disease have more than doubled over the past 10 years, accounting for 5.9% of all deaths in 2009 compared to 2.8% in 2000. Dementia and Alzheimer’s disease are now the third leading cause of death overall. Dementia and Alzheimer’s disease are most prevalent amongst females where they are the third leading cause of death, compared to sixth for males".

We have the tools: lets use them.

Traumatic Brain injury

Tweet There have been a number of highly publicized reports of Traumatic head Injury - TBI - recently, involving the now infamous "One punch" deaths, and also involving contact sports such as AFL and Rugby Union. As parents, this is of great concern. None of us expect our healthy offspring to leave home and end up in hospital or the morgue after a social night out, or even worse, playing the sports they love. But head injuries are a reality, and we need to do more to educate and improve where we can.

Even if there is no apparent ill effect of a TBI from, say skate boarding or a bike accident, there may be longer term side effets. According to researchers from the Perelman School of Medicine at the University of Pennsylvania, "A single TBI may initiate long-term processes that further damage the brain. TBI is an established risk factor for later development of cognitive impairments, such as Alzheimer's disease".

In Alzheimers disease, the post-mortem findings in the brain  show what are described as Tau Tangles and Amyloid Plaque: and these "..are appearing abnormally early in life, apparently initiated or accelerated by a single TBI".

The brain is encased in bone and floating in a thin skim of fluid to help protect it against trauma and subseqeunt head injury. But these days, we travel at far greater speeds than our body was ever designed for, and the impact of contact sports is probably far more "energy intense" with current methods of  weight training: so the likelihood of a TBI is greatly increased.

We need to match our skill in improving our speed with our methods of protecting the human brain, in order to reduce the short term pain and the long term degeneration that brain injuries can cause.

Bowel Cancer

Tweet Colon cancer - known in the medical profession as Colo-Rectal cancer - is the most common cancer in Australia, after skin cancer: and it is the second most common cancer-related cause of death: it's also one of the most preventable ones too! So anything that we can do to prevent it will lead to a reduction in unecessary personal suffering and also to a reduced need to use our already stretched hospital services.

Obviously, there are screening tests that are available for those at higher risk - that is those with a strong family history, or those how are known to have multiple polyps in their bowel - and this usually means regular bowel examinations by specialists. But seeing Specialists means using the hospital services, and I'm thinking more of what each of us can do to lower their own personal risk of developing bowel cancer.

The ideal thing would be for everyone never to grow old, because aging is fraught with so many health issues: but at this stage, that is the stuff of dreams and fantasy. But according to the health experts, there are some things that may prove beneficial, and I suspect that most of you have heard of them before:

• dietary modifications - increased dietary fibre, fruits and vegetables, and decreased red meat
• other lifestyle changes - increased physical activity, weight maintenance, avoidance of smoking, and moderation of alcohol intake 

Non of these things will reverse the aging process or stop you from ever developing cancer or heart disease, but they will reduce the likelihood of you developing them: and they will make you fitter and healthier so that should you come down with either of them, then you are much more likely to survive them and recover better from them. If you do your bit to maximize your health, then that leaves the hospitals freer to look after those who need their precious resources.

Vaccinations: two great Aussie Heros bring hope.

Tweet Humans are odd creatures: here we a few years on from the so called GFC, and still there are concerns that the worst is yet to come as Greece, Ireland, Portugal, and now perhaps Italy and Spain head towards the "gurgler"! Then there's the Americans teetering on the edge of Default on their loans, which could potentially make the Euro crisis seem like a game of Monopoly!

The link to health is the sense of fear and uncertainty that this all creates: "What if it all goes wrong - what will happen to me"? Well, the simplistic answer is that you will still wake up in the morning, and you will still have your family and (most/some) friends left to talk to, and you will still worry about what you're going to have for tea! Meanwhile, out there in the real world, there are people who are genuinely trying to help make this world a better place - not by inoculating people with fear, but by leading by example, and by literally putting their money where their mouths are.

Prof Ian Frazer, he of the Cervical cancer vaccine, is working on another vaccine; this time for Herpes infections - one of the other pathogens linked to the cause of Cervical cancer. He's apparently been working on this for some years and even had to create his own company in order to bring it to a stage where "Big" backers have started to share in his vision: one of these being Andrew Forrest, who as well as exporting large chunks of the country to China, is also an amazingly philanthropic person. So if you want to divert your attention from gloom and doom to hope and help, then keep an eye out for Coridon - Ian's research company.

The other person who always sees the glass half full is Barry Marshall, the Nobel Laureate, who is also working in the field of vaccines. Barry is persuing the dream of creating a "no needle" vaccine based around his "pet" bacteria - Helicobacter. By fiddling with the genetic structure of the bacteria he hopes to be able to create a friendly bug, that will live in the stomach, and yet create an antibody response to the small parts of the disease-causing microbe which he will attach to it, and against which you want to vaccinate. And like Ian Frazer, he's created his own company to try and turn his ideas into a reality. So check out Barry's company too: it's called Ondek.

Exercise helps control Panic Attacks

Tweet Ever have those thoughts such as 'I'll have a panic attack,' 'I'll die,' 'I'll go crazy,' 'I'll lose control' or 'I'll make a fool of myself, then you may have what is called a high anxiety sensitivity which means that you may have a greater risk for developing panic attacks and other psychological disorders.

The good news is that relief is at hand – or more likely at foot – because recent research has shown that those with a heightened anxiety sensitivity and who engage in high levels of physical activity will lower their anxiety levels in response to those panic inducing events. This backs up long known evidence for the use of physical activity as another tool in the armoury to help with mood disorders such as anxiety and depression.

Jasper Smits, lead author on the research at Southern Methodist University in Dallas and the University of Vermont in Burlington, added the proviso that "We're not suggesting exercise instead of pharmacotherapy or psychotherapy: exercise is a useful alternative, particularly for those without access to traditional treatments. Primary care physicians already prescribe exercise for general health, so exercise may have the advantage of helping reach more people in need of treatment for depression and anxiety."

So there you go: don’t be afraid, kick off your work clothes and put on the runners and then hit the road/park/beach/gym: in fact anything that will help you to do as Olivia Newton-John suggested in song: “Lets get physical”! Beats sitting in a waiting room!

Gonorrhoea - the scourge of the Ages

Tweet Oh dear: I have to report some bad news! When the lethal E Coli outbreak occurred recently in Germany, alarm bells began to ring (again) over the possibility of a new, resistant organism sweeping around the world: luckily for those not involved, we have been spared from a potentially awful illness.  But we've also had chicken and swine flu; and in the Eastern States we've now got the spectre of Hendra virus from bats, via horses! However, it's an ancient disease of mankind that is rearing its ugly head again with the news that a strain of Gonorrhoea has appeared that is resistant to all known antibiotics! So for those of a promiscuous bent, be afraid - be very afraid!

Gonorrhoea is a sexually transmitted disease that has plagued man,  and woman-kind since time immemorial. It presents with a discharge from the vagina in women, and from the penis in men: not surprisingly, men tend to notice the problem more frequently than women, but the consequences for both can progress to infertility. But worse things can happen: skin rashes and infected joints, plus an increased risk of getting HIV - definitely not a good look on your CV for life! But should a pregnant women give birth, whilst infected by Gonorrhoea, there is a real risk that the child - if infected during the descent through the birth canal - will become blind because of the infection.

In 2009 there were over 3,200 cases confirmed here in Australia, 2,622 in men and 596 in women: so this is not an uncommon problem. In the USA it is anticipated that there will be over 700,000 cases reported this year: so the fact that a new, totally drug resistant strain has appeared, completely changes the way people must approach casual sex.

Intimacy is beautiful: sex within an intimate relationship is beautiful too. Casual sex may appear attractive; but the consequences may last longer, and be worse, than you thought.

Oh for the simple life

Tweet Remember those good old days when the baddie always wore a black hat and the good guy wore a white one? I remember being taught in Medical school that there were three deadly white poisons: white flour, white sugar and heroin!! If only it were as clear cut as that - even heroin is a fantastic pain killer in Palliative Care.

I was reminded of how muddy the waters can be when "pontificating" on health matters, by an article in the Weekend Australian on the simple subject of sugar: which for many decades has been the "bete noir" in the obesity and diabetes stakes. Many patients that I've had over the years, when it comes to being told they have diabetes, respond with "That's all about sugar isn't it"? The simple answer is, "No, it's not just about sugar" - it's about healthy eating and effective physical activity. In fact, according to Jenny Brand-Miller, the University of Sydney Nutritionist, too much dietary information is out of date and eating sugar is not "inherently dangerous".

One of the problems in promoting good health is that we go for the simple headline, the "catchy" phrase to encompass a subject that is so big and so varied in nature. Obesity, and all the related health issues that go with it can be improved if you eat good quality food in the right quantity and get an appropriate form of physical activity on a regular basis - according to who you are, and where you are in your life; and that - as we know - is constantly changing: so one size will never fit all, despite so many health organizations trying to convince us otherwise.

What gets my goat at the moment, is the bullying and hectoring that some "health lobby" types use to press their message: in particular when prosletysing about their current hobby horse, alcohol - a toxic poison when used incorrectly, but one that when used appropriately, does have health benefits as well as making those healthy eating occasions, so much more pleasurable. This is another of those "one size fits all" health issues that just doesn't add up: some people should never drink alcohol because they just can't stop after one drink, and I respect their wise decision never to drink. Most young people of Anglo Saxon heritage seem to think that the purpose of alcohol is to make you vomit and black out - these young people need a serious lesson about the terrible toxicity of alcohol. Interestingly, most Italian, French and other non Anglo communities appear to be able to educate their young people far more "creatively" when it comes to alcohol. When it comes to the health negatives such as cancer, and the health benefits, such as heart disease: then I suggest we lock those experts up in a room and don't let them out until they sort it out; and then let us know where the real truth may lie!

Blisters

Tweet I got a Text message from my son this morning with an attached photograph of the "mother of all blisters" on his foot! I have to admit that I was mightily impressed by its size: but then he had just walked over 30kms in preparation for a Charity walk, where he and his friends hope to complete 100kms in 24 hours to raise money for Oxfam - which is even more impressive!

But blisters on the feet are a real leveler when it comes exercise and can affect anyone who is trying out new runners or new boots. The first tell tale sign is a "hot spot" where the skin is starting to look red and feel tender: this usually occurs over bony eminences such as the bunion bone or the heel, but can be more disabling when it happens to the "ball of the foot" area.

My recommendation is to use a generous piece of Fixomull to cover the area and the surrounding skin to give an extra layer of protection; then leave the dressing on for as long as possible (maybe 3 to 4 days) to allow the skin to recover. Fixomull is great stuff because you don't need to change it if it gets wet,and it's perfectly OK to leave it on after you've had a shower. If you do get a blister, where the surface area of the skin shears against the growing area of the basal layer of skin, thus causing fluid to accumulate as a blister; then do exactly the same thing - cover it with Fixomull and leave well alone until the dressing comes off. Even if the blister bursts and oozes through the dressing, just let it dry out and leave it alone. This gives the tender growing skin at the base time to "toughen up", and the dead, surface skin of the blister acts a a good barrier to potential infection. If, however, the area of the blister starts to throb and get more painful, and even start to smell, then that suggests an infection is starting and you should get it checked by your GP.

Of course, the best thing is not to get a blister, and that means making sure your footwear is appropriate to the task - and that includes your socks! But it's not just skin that can suffer due to pressure from shoes: if your toes press against the end of your boots and you walk or jog long distances, then you may get bleeding under the nails and eventually they will fall off!! Be not alarmed - they will regrow, but that will take about 6 months, and in the meantime, you might get a few frightened looks from small children when they ask what's happened to your toes!!

Gardening - beauty and the beasts!

Tweet I've just come in from the garden where I've been trying to take some cuttings so that I can replace a low hedge that has died from another of those mysterious diseases that seem to plague this amateur horticulturist! I don't think they died from neglect, as they have been a most pampered species since arriving chez nous some 5 years ago: but now, one by one, they are "slipping off the twig"! It's probably a mineral deficit, or a fungal or viral infection- a bit like we humans really -, but sadly they're heading for the re-cycling bin!

Meanwhile in the composter, the cockroaches seem to have found their own Nirvana: that is until I blasted them with some noxious neuro-toxin known as a Cockroach Bomb, which seems to have been effective not only on those 'orrible creatures, but also on worms and Slaters - or wood lice as they're called in the old country. I'm not surprised that farmers have an increased risk for neuro-degenerative diseases such as Parkinson's if they have to use industrial quantities of such amazingly deadly chemicals!

Luckily, at this time of year the insect load is at it's lowest, so less danger of stings from bees or wasps: but nature, abhorring a vacuum, gave up Ticks!! Being a keen walker, we often go through the bush at this time of year to appreciate the amazing wild flowers that are starting to appear here in WA: and bush country is tick country: and ticks being parasites, love the taste of blood - anyone's, or anythings blood! In this part of the world there hasn't been too much research on tick born disease, but in other parts of the world there's Lymes Disease and Rocky Mountain Spotty Fever - neither of which do you want to get!

But back to suburbia. The serious gardener will wear gloves, not that it helps much when it comes to pruning rose bushes which seem to find the cracks in Kevlar body armour: and of course we love to put horse manure on roses, and horse manure can be teeming with Tetanus! So, all you happy horticulturists, get a tetanus booster because tetanus is an extremely horrible illness, and an ounce of prevention is better than a pound of cure!

And for those who love to "potter" in the potting shed and plant up those freshly taken cuttings: beware - potting mix in an enclosed area can give you a very nasty lung infection if you inhale the spores that it contains. If you're dealing with any rotting, or manure based mix, always do it outdoors, and I suggest you wear a mask too. And whilst on wearing masks, in order to control many garden pests, we do use sprays of various sorts: as a wise man said -"read the instructions, read the instructions, read the instructions" when it comes to safety instructions. Then you're far less likely to get a skin, eye, lung problems as a result of inappropriate exposure to toxic chemicals: and do remember to store your Chemical warfare agents safely under lock and key, away from prying, playful little fingers!

Otherwise, gardening is awesome and a balm for the weary soul! I love it and encourage as many as possible to get out and get dirty: it gives you the chance to not only stop and smell the roses, but to literally enjoy the fruits of your labour too!

Hendra and other deadly viruses.

Tweet There has been much in the press recently about the outbreak of Hendra virus in Queensland which has led to the death of a number of horses and to the very real health scare for those who have treated, and handled the sick animals.

The human race has been afflicted for millenia with "plagues" which have devastated communities and then virtually "disappeared". The bubonic plague was one that killed almost half of Europe in the middle ages, and is rarely heard of these days, although it is still "out there" and still occasionally killing people. Of course there are other epidemics that crop up from time, measles, influenza and now HIV which has been with us probably since the 1920's.

As I pointed out in an earlier article, the human race has only been around for about 20,000 generations, whilst bacteria and viruses have been around for millions of generations and have had longer to learn how to adapt far more quickly than we humans have. The other thing that has happened is that within the last four generations, homo sapiens has gone from living his life in a village surrounding, to now being a globe trotter extraordinaire! That, plus the world population now being around 7 billion means that infections can now travel much farther, much quicker and in a larger population than ever before.

The final piece of the jigsaw is that we live in much closer proximity to the pool of germs that cause these infections- animals, birds etc - so it so much easier for these germs to "jump species". Measles came from animals where it is known as Rinderpest. Bubonic plague -AKA Yesenia Pestis - is spread by flea infested rats, where it is the flea that does the biting and the rats do the spreading!! Influenza comes from birds and especially the wild, migratory ducks that call China home. And of course HIV comes from Chimpanzees in Africa and spread to humans when it was used as a source of food in the last century.

But it is not just a one way street: humans gave cattle bovine TB, and in America passed leprosy onto the Armadillo which on occasion has returned the compliment, leading to sporadic outbreaks in those areas where skinning armadillos is seen to be a fun idea.

Thankfully, we have good vaccination programs to help control many of these devastating diseases, but because these organisms are quick to adapt, and because humans are so omnipresent, it is highly likely that we will face some very serious epidemics in the decades to come: you have been warned!

Trouble remembering a face?

Tweet Then perhaps you could learn a lesson from feral pigeons! These "flying rats" as my elder brother calls them, are smarter than you might have thought: and they can remember your face.

According to researchers in Paris, from the University of Paris Ouest Nanterre La Défense, these untrained pigeons never forget your face and are not fooled by a change of clothes. In  paper presented at the Society for Experimental Biology Annual Conference in Glasgow, they reported how they used two researchers of similar size and features, but wearing different coloured Lab coats, who either ignored or chased away the feeding feral pigeons. Then they swapped coats and both ignored their feathered friends: the birds gave the aggressive researcher a wide berth, even though he just sat there quietly. As the lab coats covered 90% of them, all the birds could work on was the facial features of the researchers.

So next time you pass someone in the street and fail to recognize them, if they call you a bird brain: take it as a compliment!

Grieving

Tweet We went to a funeral the other day: most people in science and the medical profession don't talk about death unless it happens to someone close to them, but one thing is certain in life and that is that we will all die. One of the challenges that medicine faces is that it is often see as searching for a "cure" for cancer and a "cure" for heart disease, our two biggest "killers"; when what is really happening is that we're relieving one problem and delaying the inevitable.

Funerals are a difficult time because of all the raw emotion involved, and I always stand in awe of grieving family members who get up and deliver loving eulogies that are obviously gut-wrenching to perform: I often find myself heaving with suppressed sobs as I listen to them. The service I attended was a Catholic service and not only gave great dignity and ceremony to this final farewell for the person who had died, but provided a framework for those who were saying their loving farewells, to complete this traumatic episode in their lives.

Two poems during the service helped illustrate both the awful emotion of the final farewell, and the hope that those with faith have and which helps nurture them in life. The first poem was made "famous" in the film "Three weddings and a funeral" and is by W.H. Auden, and starts:

Stop all the clocks, cut off the telephone.

Prevent the dog from barking with a juicy bone,

Silence the piano and with muffled drum

Bring out the coffin, let the mourners come.

The final verse goes:

The stars are not wanted now; put out every one,

Pack up the moon and dismantle the sun.

Pour away the ocean and sweep up the wood;

For nothing now can ever come to any good.

It really sums up how one must feel when your nearest and most beloved is being laid to rest forever.

The other poem was probably written some 3,00 years ago and is found in the Bible in the Song of Songs, and provides some hope and comfort for those with Faith:

My lover speaks to me,

"Come then, my love;

My darling, come with me.

The winter is over;

The rains have stopped;

In the countryside the flowers are in bloom.

This is the time for singing;

The song of doves is heard in the fields.

Figs are beginging to ripen;

The air is fragrant with blossoming vines.

Come then, my love;

My darling, come with me".

Close your heart to every love but mine;

Hold no one in your arms but me.

Love is as powerful as death;

Passion is as strong as death itself.

It bursts into flames and burns like a raging fire.

Water cannot put it out;

No flood can drown it.