Quicky sickie

With doctors’ queues lengthening, Ireland could be next in line for digital sick notes, writes Maurice Gueret, who escaped back home without getting London Throat

Malady note

It’s no surprise that France is keen on a new online business supplying sick notes by email for a fee. The country has the sickest workforce in Europe by some distance, averaging three weeks of sickies every year, one week more than in Ireland and two more than in the UK. For a charge of €25, a new sick-leave website called arretmaladie.fr makes getting a doctor’s note as easy as ordering a pizza. Or so say French GPs, who are aghast at the notion. I tried it. You simply click one of seven ailments — coupe de froid; gastro-enterite;

douleurs menstruelle; stress; douleurs de dos (backache); migraine; or cystite; then you answer a questionnaire and a doctor rings you back (make sure you are in bed) for a brief video chat. The service was started in Germany, where more than 30,000

krankschreibunges have been issued to date. The person at the helm is Dr Can Ansay, a doctor of law who describes himself as an e-health disruptor. Things happen quickly in the digital world, so it may not be long before such a service arrives in Ireland. I think quickysickie.ie has a good ring to it. Should queues get any longer at GPs and hospitals, a digital death-cert app might also prove a winner.

Procto doctor

We’ve been looking through the Irish family medicine cabinet in recent weeks, picking out remedies for comment. This week it’s the turn of procto products. The words ‘anus’ and ‘rectum’ don’t sit comfortably in the world of marketing, so the Greek word for these unmentionables, proktos, comes to the rescue. Americans worship their proctologists. But in this part of the world, we refer difficult cases to physician gastroenterologists or general surgeons who sub-specialise in lower GI or colorectal surgery. Procto products in your medicine cabinet treat the pain and inflammation associated with haemorrhoids. Some are also used to treat fissures or tears, pruritus and proctitis — all uncomfortable conditions, especially when sitting on a bus. Ointments such as scheriproct, ultraproct and proctosedyl contain steroids of varying strengths, as well as a long-used surface anaesthetic called cinchocaine. Another stalwart of the pile-soothing world is an over-the-counter product called Preparation H. It comes in both ointment and suppository form. Ingredients are shark liver oil (no teeth, thankfully) and an alcoholic extract of yeast. If you have any other cupboard gems from the haemorrhoid world, do let me know at mgueret@imd.ie.

Viking claw

I had a lovely letter on foolscap from a gentleman who lives in Dublin. We’ll call him Tom. He was referred to the Mater for treatment of what sounds like a Dupuytren’s contracture, with fingers so bent they were pressing into the palm of his hand. Tom came around after surgery and a nurse brought him tea and toast. As his arm was in a sling, she even buttered it for him! Best toast of his life, says Tom. Anyhow, the surgeon told him that some Irish people get contracted fingers like his because of Viking blood. Tom was a bit sceptical about this as his brother had mapped the whole family tree back to Roscommon in 1750. But last year, Tom discovered that a sister of his who lived abroad had her blood genetically analysed following a bout of cancer. It suggested that she was 95pc Irish and 5pc Scandinavian. His surgeon was onto something, after all. Dupuytren’s contracture is named after a brilliant French surgeon who first explained it in the 1830s. With the possible exception of Japan, it is mainly confined to people of European descent, with the highest incidence reported in Iceland and Scandinavia.

Froggy throat

I returned in good health from a recent jaunt up Old Father Thames to read in the British Medical Journal of a new condition called London Throat. It refers to a ‘constant froggy feeling’ with very frequent coughs and colds for metropolitan victims. The phrase was coined by Dr Liza Selley, an air-quality toxicologist. According to the journal, the multiplicity of speed bumps in cities and suburbs, and incessant speeding and breaking, cause small particles to be knocked off tyres, brake pads and exhausts. Researchers at King’s College London have linked these tiny metal fragments with inflammation and less ability to fight airway infections. The solution could be bump-free roads and a 30km-per-hour speed limit in all cities. Or electric trams for all of us.