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Why gar­den­ing gloves can help weed out sep­sis

- DR MARTIN SCURR Health · Pharmaceutical Industry · Health Tips · Mental Health · Medications · Medicine · Healthy Living · Gardening · Industries · Health Conditions · Pharmacology · Hobbies

QWE’RE con­stantly warned to look out for — and recog­nise the signs of — sep­sis, which can de­velop from a tiny scratch or abra­sion. What we are never told is how to pre­vent it in the first place. What is your ad­vice?

AIan Charles, Shrews­bury. Sep­SiS is the con­se­quence of an extreme re­sponse to an in­fec­tion — the im­mune sys­tem is ei­ther over­whelmed by or over­re­acts to this in­fec­tion.

The in­fec­tions that trig­ger this could be quite lit­er­ally any­thing — from an in­fected in­grown toe­nail, to a bout of pneu­mo­nia to quinsy — a com­pli­ca­tion of ton­sil­li­tis.

The over-re­ac­tion be­gins with the im­mune sys­tem trig­ger­ing the re­lease of chem­i­cals called cy­tokines that en­cour­age the blood ves­sels to widen, which can re­sult in a dra­matic drop in blood pres­sure. This can then lead to the most se­vere el­e­ment of sep­sis — sep­tic shock, when or­gans start to fail due to the lack of blood sup­ply.

The risk fac­tors in­clude any­thing that may im­pair how well the im­mune sys­tem works. For ex­am­ple, ad­vanced age (be­ing over 65), a com­pro­mised im­mune sys­tem (as a re­sult of, say, nec­es­sary treat­ment for some ill­nesses such as can­cer), pre­vi­ous hos­pi­tal­i­sa­tion (par­tic­u­larly if time was spent in in­ten­sive care), and pneu­mo­nia, di­a­betes, and obe­sity.

Although, as you say, sep­sis can de­velop from a small scratch or abra­sion, the type of or­gan­isms that might be in­tro­duced and the risk fac­tors that i have de­tailed above are of rel­e­vance; gash­ing your fin­ger on a clean kitchen knife is un­likely to lead to sep­sis, but a cut from a mu­den­crusted tool in the gar­den might.

in terms of pro­tec­tion, wear­ing gloves when gar­den­ing or work­ing with tools, and gen­eral mea­sures that en­hance im­mu­nity — a healthy and nu­tri­tious diet, some reg­u­lar ex­er­cise, enough sleep, main­tain­ing a nor­mal body weight and avoid­ing smok­ing or ex­ces­sive al­co­hol in­take — may all be ben­e­fi­cial.

And if any mi­nor in­jury or skin in­fec­tion ap­pears to be wors­en­ing or spread­ing rather than re­solv­ing af­ter a nor­mal ex­pected pe­riod of time, then seek med­i­cal ad­vice.

QFOR more than 20 years I have ex­pe­ri­enced headaches last­ing two or three days, but re­cently they’ve lasted two months. The pain is dull and ac­com­pa­nied by tin­ni­tus and is just about bear­able, although there are days I have to take painkiller­s.

It is not mi­graine, which I’ve had in the past. My doc­tor said they couldn’t be se­ri­ous and gave me gabapentin. But I had side-ef­fects, so weaned my­self off. I also have aching eye­balls.

APeter Ormsby, Here­ford. i ShAre the view of your Gp: the headache, de­spite per­sis­tence over two months, is un­likely to be sin­is­ter.

Nev­er­the­less, a ques­tion re­mains about the ex­act di­ag­no­sis. You say that you have pre­vi­ously had mi­graines but i ques­tion your cri­te­ria for dis­miss­ing that di­ag­no­sis this time.

Mi­graine is di­vided into two broad cat­e­gories: mi­graine with aura and mi­graine with­out aura. in the for­mer, there is a headache in ad­di­tion to other neu­ro­log­i­cal symp­toms.

These may in­clude vis­ual dis­tur­bances (such as a par­tial loss of vi­sion or see­ing bright spots with geo­met­ric shapes), sen­sory changes in­clud­ing tin­gling or numb­ness of part of the face or arm, and mood changes. These typ­i­cally start an hour be­fore a headache be­gins.

in mi­graine with­out aura there is a mod­er­ate or se­vere headache, which may last a few hours or a few days, of­ten with nau­sea or vom­it­ing (which may also oc­cur dur­ing mi­graine with aura) and pain, which may be con­fined to one side.

My ex­pe­ri­ence of pa­tients with mi­graine over many years is that it is pos­si­ble for some­one to ex­pe­ri­ence ei­ther form of mi­graine from time to time, and i think this is what you are ex­pe­ri­enc­ing.

i sus­pect the few episodes that you de­scribe as mi­graine in your past may have been mi­graine with aura that had ac­com­pa­ny­ing dra­matic or alarm­ing vis­ual dis­tur­bances which is what led you to make the di­ag­no­sis. i sus­pect your more fre­quent headaches are mi­graine with­out aura.

The cur­rent two-month headache may fall into another cat­e­gory, called chronic mi­graine (also known as chronic daily headache. This is a headache oc­cur­ring for 15 days or more in any given month and which may vary in in­ten­sity from day to day.

The eye­ball ache you de­scribe can be part of mi­graine; in some pa­tients, mi­graine pain is in the eye only.

Treat­ments for chronic mi­graine have not been as well stud­ied as those for the other, ‘episodic’ mi­graine.

it is dis­ap­point­ing that gabapentin caused un­ac­cept­able side-ef­fects as that med­i­ca­tion is one good op­tion.

Other treat­ments in­clude the an­ti­con­vul­sant drugs top­i­ra­mate, val­proate and pre­ga­balin, and the an­tide­pres­sant amitripty­line — these can re­duce the in­ci­dence of mi­graine headaches (pos­si­bly by damp­en­ing down pain nerve sig­nals), so i would dis­cuss these op­tions fur­ther with your doc­tor. An al­ter­na­tive is to buy coen­zyme Q10 cap­sules, a nat­u­ral sub­stance al­ready present within the cells of the body.

Take 100mg once or twice daily, and also take ri­boflavin ( vi­ta­min B2), 200mg, daily. There is am­ple re­search that both can be of value in mi­graine pre­ven­tion.

Note it will be at least a cou­ple of months be­fore you will see any ef­fect, and as these are non-pre­scrip­tion sup­ple­ments, there is an ex­pense to bear.

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