September 2003

Contributed by readers • Edited by Donald B. Middleton, MD
 

SLICK IDEA

Occasionally even the most experienced pill-swallowers suddenly develop a "stuck-in-the-throat" sensation that can be disconcerting and recurrent. I always worry about esophageal cancer, stricture, or neurological disease in this circumstance [see "GI Consult" for more on that topic—Eds.]. To get around it, patients often cut pills in half, crush them, or put them into some food like jelly, honey, applesauce, or ice cream. From Lincoln Park, Michigan, Dr. Basil Rodansky's suggestion is to dunk the tablet in a creamy salad dressing as a means of lubrication. A cold drink before swallowing can also help.
 

TEAM SPECULA

To examine a patient with collapsing, redundant vaginal walls, Dr. Catherine Vretta from Detroit, Michigan, employs two specula. After inserting the first speculum in the usual vertical position, she inserts a second horizontally. The opposing devices provide a better view than a single speculum affords, she says.
 

CARROT PACK UPDATE

Years ago, Dr. Edward Gaber read an 1888 medical journal article that espoused "carrot packs" for treating sore throats. So he tried biting into some vitamin A capsules and found that they immediately relieved throat irritation. Since then he has advised patients to buy 10,000-IU vitamin A gel caps to chew on when pharyngitis strikes. The patient can take up to three capsules on the first day, up to two on the second day, and one a day thereafter if needed. The total course should be limited since excessive vitamin A intake can cause severe headache or other major problems, and the capsules need to be stored out of reach of young children.
 

GI COCKTAIL

From Los Altos, California, Dr. Gus Garmel offers a new "GI cocktail" for esophagitis. He uses large amounts of antacids (30 to 60 ml) mixed with an appropriate dose of acetaminophen elixir and, sometimes, 5 to 10 ml of viscous lidocaine to get a barrier coating, pain relief, and anesthesia in a few swallows.
 

PRESSING DECISION

To facilitate diagnosis of skin lesions, Dr. Martin Hecht in Brooklyn, New York, gently presses a sturdy glass over them. Lesions thus flattened can then be evaluated more easily with tangential illumination to allow a better decision about removal. Those that cannot be compressed may need to come off.
 

RING OF TRUTH

The great variety of techniques that readers recommend for removing a ring from a swollen finger attests to the difficulty of the feat. From Visalia, California, Dr. Michael Solis suggests soaking the finger in hypertonic saline for 15 to 30 minutes to osmotically extract water from its edematous tissue. Rather than cutting a precious ring off, this idea seems worth a try.
 

WRAP IT UP

Everyone knows about substituting the stopper from a blood drawing tube for the missing earpiece on a stethoscope, but Dr. Chris Dutra in Berkeley, California, finds that wrapping several layers of plastic tape around the metal opening works just as well. These days, with blood drawing tubes hidden away as often as they are, Dr. Dutra's solution sounds like a handy alternative. How do those earpieces escape so often, anyway?
 

COOL ANSWER TO A BURNING QUESTION

Do you have patients with sunburn or first-degree burns looking for pain relief? In Gainesville, Florida—where they ought to know about sunburn—Dr. John LeFevre tells patients to put a bottle of skin moisturizer containing aloe vera into the refrigerator for about an hour, shaking it at least once at about the half-hour mark. This refrigerated lotion provides hydration, the healing power of aloe vera, and immediate relief from the cooled liquid.