Corked mus­cle needs TLC

The Weekend Australian - Travel - - Health -

My 16-year-old son re­ceived a knee to the out­side of the thigh dur­ing foot­ball train­ing. We ini­tially treated it with ice for 20 min­utes ev­ery two hours and he has been rest­ing. How soon should we start mas­sag­ing the area with an an­ti­in­flam­ma­tory gel? And how long should he take to re­cover be­fore he starts re­sum­ing full train­ing and play­ing footy? AS you prob­a­bly know, the corked thigh is in fact a bleed into the mus­cle. The ice and rest treat­ment ini­tially is ideal, as it helps stop the bleed­ing. The only other treat­ment that is of­ten rec­om­mended in this acute phase (the first 36-48 hours af­ter the in­jury) is com­pres­sion, which can also help cur­tail the bleed. Fol­low­ing this, the treat­ment usu­ally in­volves a se­ries of gen­tle ac­tive ex­er­cises and stretches, rather than anti-in­flam­ma­tory gels. The com­mence­ment and in­ten­sity of this is best su­per­vised by a phys­io­ther­a­pist, or a doc­tor with a spe­cial in­ter­est in sports medicine. If mas­sage or ex­er­cise is started too early or is too vig­or­ous there is a risk of de­vel­op­ing myosi­tis os­si­f­i­cans, where bone forms in the blood clot. Re­cov­ery time gen­er­ally de­pends on the sever­ity. Mild cases can im­prove within a week, whereas se­vere cases can take up to two months. My friend has tha­las­saemia, which was di­ag­nosed on a blood test a few years ago. She is well and doesn’t seem con­cerned about the con­di­tion, though I have heard it could af­fect her chances of hav­ing chil­dren. Is this right? THERE are two dif­fer­ent types of tha­las­saemia — ma­jor and mi­nor. It is most likely your friend has the mi­nor type, which is milder. The more se­ri­ous con­di­tion, tha­las­saemia ma­jor, is a dis­or­der that af­fects the pro­duc­tion of haemoglobin and can re­sult in se­vere anaemia. Peo­ple with tha­las­saemia ma­jor have two copies of the gene — one in­her­ited from each par­ent. Peo­ple with tha­las­saemia mi­nor have only one copy of the gene and have no symp­toms. This is known as the car­rier state, and it is fairly com­mon, es­pe­cially in peo­ple from the Mediter­ranean, the Mid­dle East, South-East Asia and the In­dian sub-con­ti­nent. Tha­las­saemia mi­nor will not af­fect fer­til­ity, but if your friend’s part­ner is also a car­rier of the con­di­tion, there is a one-in-four chance they could have a baby with tha­las­saemia ma­jor. How­ever, there is ge­netic test­ing avail­able to see if some­one is a car­rier of tha­las­saemia if the sit­u­a­tion arises. I AMa 60-year-old fe­male. My last pe­riod was in 2001, but I have been hav­ing hot flushes day and night since 1999. I had a to­tal hys­terec­tomy last year, but the flushes have con­tin­ued, al­beit less fre­quently. I don’t take hor­mone re­place­ment ther­apy as I have a fam­ily his­tory of breast can­cer. Is there any­thing else I could try? WHILE it is cer­tainly pos­si­ble to have hot flushes con­tinue for eight years, it is rel­a­tively un­usual. There­fore, it might be worth­while — if you haven’t had one al­ready — hav­ing a full check-up to make sure the hot flushes are not re­lated to some con­di­tion other than menopause, such as thy­roid dis­ease or di­a­betes. Also, un­less your hys­terec­tomy in­cluded the re­moval of your ovaries, it was un­likely to af­fect your menopausal symp­toms. As for treat­ing the hot flushes, hor­mone re­place­ment ther­apy is the gold stan­dard — but there are a num­ber of al­ter­na­tive op­tions. There is some ev­i­dence to sug­gest a diet high in phy­toe­stro­gens is as­so­ci­ated with fewer menopausal symp­toms, in­clud­ing hot flushes. So that means more soy milk, tofu, tem­peh and miso. Sim­i­larly you could try phy­toe­stro­gen (isoflavone) sup­ple­ments, al­though the ev­i­dence for th­ese has shown mixed re­sults. Sim­i­larly, black co­hosh sup­ple­ments have some sup­port, so could be worth a try. Dr Cal­abresi is a GP and ed­i­tor of Med­i­cal Ob­server. Send your queries to linda.cal­abresi@medobs.com.au

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