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Update September, 2019

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Doctor's Consultation  by Dr. Iain Corness


The hewers of stone and drawers of water

With the current push for women’s health clinics and practitioners, it is easy for men to feel left out. After all, you’ve no uterus to become cancerous, and although you do have vestigial breasts and it is theoretically possible to get breast cancer, I don’t suggest you go looking for breast lumps every month after your non-existent periods.

However, there are some specific male areas, and these centralize around the genito-urinary systems. In the medical business, Urologists are sometimes called the hewers of stone and drawers of water, because much of their work deals with kidney stones and assisting men to be able to pass water adequately. We men do suffer at times, it’s not only the ladies who have ‘specific’ problems!

Your urinary system is a remarkable collection of organs, beginning with the kidney, the “super filter”. The kidney filters the blood and allows the important stuff like blood cells and nutrients to continue waltzing around your circulation, but taking out the nasties, and at the same time helping balance the acidity/alkalinity of the body. Clever little organs, the kidneys!

To keep your kidneys in top shape does not require special kidney exercises, you will be pleased to know. In fact, there is nothing you can do ‘physically’ to make the kidneys perform, but fortunately there are some things you can do to keep them in top condition.

The first is to drink plenty of water every day. And by ‘water’, I mean the plain and simple H2O style water, not the stuff that has been mixed with hops, distilled with grain or left to age in oak casks. Making the kidneys exercise, to filter and regulate the circulating blood volume, is simply carried out by drinking several liters of water every day. Yes, it is that easy. On your desk at work keep a glass of cold water beside you and empty it every 30 minutes. Into your gut, not the sink.

The advantages you get from this are enormous. First off, you have immediately lowered the chances of forming kidney stones, a potentially dangerous (and always painful) condition. Being a card carrying coward, I have always preferred the drinking water option to the lying in bed groaning with pain alternative. In fact, around 15 percent of people will experience stones in their lifetime (especially in the hot climates) and men outnumber women between two to three times. We also know that if you do not change your lifestyle, you are very likely to develop another stone within two years after the first episode. We men do suffer at times, it’s not only the ladies who have ‘specific’ problems!

The kidneys drain to the bladder by two tubes called Ureters. These do not do much, other than connect the kidney to the collecting vessel (bladder). However, if a piece of stone gets stuck, you will soon know about it. Renal colic sorts out the men from the boys! Ultimate pain! Down on your knees type pain.

From the bladder, the urine gets introduced to the outside world by another tube called the Urethra. This is short in ladies and is the reason that women get Cystitis (bladder infections). It is longer in the men folk, allowing us to stand up to pee and become obsessed with how long or short it really is. After the age of 40 give up the ‘Who can pee the highest’ competitions.

However, we chaps have another problem in that region, as far as getting the urine from the bladder to the far wall of the urinal. This is called the Prostate, and it encircles the Urethra and when enlarged, closes down the internal diameter of the pee tube. This makes it difficult to pass water and you dribble on your shoes. The prostate can also become cancerous, an even less pleasant state of affairs. We men do suffer at times, it’s not only the ladies who have ‘specific’ problems!

Yes, you can have a check-up for this area too. Just ask to see the hewers of stone and drawers of water!

Drug Addiction

When I was a young doctor, I had a somewhat morbid fascination with the reasons why my colleagues would be ‘struck off’. Each month, in the back of the British Medical Journal there would be the list of disciplinary hearings and their findings and penalties, including de-registration, otherwise known as being ‘struck off’. And the majority was for illegal drug use.

This I found simply flabbergasting. How could my senior colleagues (in those days just about everyone was senior to me), get the drug habit, when we had all been taught that it was something we had to treat very vigorously? And it was something that was very difficult to treat as well.

All of the above remained in my subconscious until one fateful day, many years later, that I was to come face to face with Pethidine, one of the drugs of addiction. Not that I hadn’t met, or prescribed Pethidine before that, but this was a very different set of circumstances.

It was mid-afternoon in my small, but very busy suburban clinic. I was a solo GP, and the staff consisted of my practice nurse and myself. The waiting room had spaces for eight patients, and the waiting list by 3 p.m. had the queue going out the door and on to the footpath outside. It had been a long day and it was going to be a longer one to come.

It was then that a 10 year old boy was brought in, having fallen off his bicycle outside. He was in great pain and I didn’t need an X-Ray to tell that his forearm was broken. Well, either that or he had two elbows on one arm. My practice nurse rang for an ambulance, while I began treatment. The lad was in so much pain, I took out an ampoule of Pethidine. This was 100 mg, but with the injured being only a youngster, I drew up half the ampoule and only injected 50 mg to ease the pain while I stabilized the fracture and we waited for the ambulance. The half an ampoule I left on the shelf above the sink. The ambulance came quickly, and the lad was driven away to the nearest hospital, while I returned to the overflowing waiting room and began trying to catch up with the workload.

One hour later, and I still had a full waiting room. There just seemed to be no end to the line of patients, and none of them were simple ‘slap on a plaster’ cases. I could feel myself becoming more and more frazzled.

It was then, while washing my hands after the previous patient, I looked up and saw the 50 mg of Pethidine looking down at me. “This stuff is supposed to give you a lift,” said a little voice in the back of my head. The temptation was almost overwhelming. The ampoule was literally dancing in front of my eyes, and it was then that I realized just how my colleagues could be caught out. Taking 50 mg today while under extreme stress, would be another 50 mg the next time I was overloaded, and then it would become 50 mg at the start of the clinical sessions, in case I became overloaded.

You can see the dizzy downward spiral. From 50 mg it becomes 100 mg and you are hooked. After running out of the emergency supply of Pethidine given to us by the government, it would be writing prescriptions for fictitious patients. All very sad, but at that instant I could feel nothing but compassion for former colleagues who had succumbed and been struck off.

I broke the ampoule and poured the contents down the sink, and returned to my list of patients. Nobody knew just what strain I had been under. Nobody knew how close, in my own mind, I had come to the brink of the abyss.

Drug addiction is a problem for medical practitioners. The workload, the lifestyle, the irregular hours are things that you are not taught how to handle in medical school. That so many of us actually manage to get through it all, is amazing. I consider myself to be lucky that I recognized it.

HEADLINES [click on headline to view story]

The hewers of stone and drawers of water

Drug Addiction



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