Health: A Question of Health

MY SPLEEN was ruptured in a car accident and had to be removed in an emergency operation. I have been advised to take penicillin daily for the rest of my life. Is this really necessary?

It is possible to live a long, healthy life without a spleen, but you are at increased risk of potentially life-threatening infections caused by the pneumococcus organism. A daily dose of penicillin will substantially reduce the risk, and many people without spleens take it for years with no apparent ill effects. You may also be offered vaccination against pneumococcal infection for added protection, but you still need to take penicillin.

OUR FAMILY is currently in the middle of an epidemic of ringworm. One child's hair has fallen out and two of us have itchy, scaly skin patches. This is the second time it has happened. Is there a way to prevent it?

Ringworm is not caused by worms, but by microscopic fungal organisms that cause a ring-shaped rash. A second attack may be caused by a dog or cat carrying the disease, with no symptoms. An anti-fungal cream will quickly get rid of the skin infection. Scalp infections may require several months of treatment by mouth. A specialist laboratory can look at scrapings from the skin to see what organism is causing it, and how to treat it.

FOR YEARS I have had an overactive thyroid gland. Each time it flares up I am treated with carbimazole tablets and beta-blockers. My specialist has now suggested radioactive iodine treatment, to cure the problem once and for all. Will it work, and is the radioactivity dangerous?

This destroys the thyroid gland so it cannot become active again. Radioactive iodine is usually given as a drink. It is active for only a few days, and the success rate is high, though you may have to take thyroxine tablets. There is no evidence of a risk of cancer or any other serious illness.

Please send questions to A Question of Health, `The Independent', 1 Canada Square, Canary Wharf, London E14 5DL; fax 0171-293 2182; or e-mail to health@independent.co.uk. Dr Kavalier regrets that he cannot respond personally.