A Question of Health

Why do paramedics on TV soaps always try to keep patients awake? Can I avoid getting cancer? And does the parrot have to go?

Good to talk?

Good to talk?

Q. When watching medical soaps on TV, I have noticed that the paramedics always try to prevent casualties from falling asleep. Is there a good medical reason for this, or is it just a myth?

A. I have also noticed that when the paramedics drag casualties out of car wrecks or carbon monoxide-filled rooms, they often seem to encourage the patients to stay awake by shouting things like "Keep talking, Joe" and "Don't let yourself drift off". But I always assumed that this was just for the benefit of television, rather than for the benefit of the patient. If a doctor or paramedic or first aider comes upon a patient who is unconscious or unresponsive, it is certainly part of the resuscitation routine to shout at the patient in an attempt to wake them up. If the patient wakes up, looks around, and asks "Where am I?", there is no need to worry about whether or not they are alive and breathing. But I can't think of any good reason why telling a casualty to stay awake will actually contribute to their wellbeing.

Prostate concern

Q. My father died of prostate cancer and I want to do everything possible to avoid getting it. He developed his first symptoms in his late fifties, but it took a couple of years before cancer was diagnosed. What is the likelihood that I will get it? What can I do to prevent it? Is it linked to diet?

A. Prostate cancer is now the most common cancer diagnosed in men in the UK. According to Cancer Research UK, it accounts for one in five of all new male cancers diagnosed. Although many young and middle-aged men worry about prostate cancer, it is largely a disease that affects older men. About two-thirds of cases occur in men of 70 and over, and below the age of 50 it is rare. About one in 13 men will develop prostate cancer at some time in their lives, but only about one in 25 will die from it. It is often said that you are much more likely to die with prostate cancer than from it. Although no prostate cancer genes have yet been discovered, the disease does sometimes seem to run in families. For someone like you, who has a close relative (a father, brother or son) who has had prostate cancer, the risk of developing it is increased two- or threefold compared with someone who has no relatives with prostate cancer. Men who have more than one close relative with prostate cancer are at even higher risk. What can you do to prevent it? There are a few dietary measures that seem to help. Taking more selenium in the diet may reduce your risk. Pulses, such as lentils, and tomatoes (which contain a chemical called lycopene) also offer a protective effect. For almost all cancers, a diet high in fruit and vegetables is beneficial. There is a continuing debate about whether it is worthwhile having the prostate specific antigen (PSA)-screening blood test. One of the problems with prostate cancer is that it is sometimes so mild as to make the treatment worse than the disease. If you want to read more about the pros and cons of PSA screening, consult: www.cancerbacup.org.uk.

Sick as a parrot

Q. I have chronic obstructive pulmonary disease (COPD). A year ago, I was given a parrot. It seems as if my breathing has got much worse and much faster than before. Is there a connection between birds and lung disease?

A. COPD is pretty common, and the people who get it usually have been smokers who have damaged their lungs over many years. The symptoms of COPD - cough, shortness of breath, sometimes wheezing - are due to the breathing passages in the lung being narrowed and scarred. There is another rarer lung disease - hypersensitivity pneumonitis (HP) - that can have similar symptoms to COPD. It is caused by exposure to fine particles in the air, mostly moulds and fungi that live on plants and animals. People who keep birds such as pigeons and parrots can get "pigeon fancier's lung", caused by dust particles with microscopic proteins from the birds and their droppings. It is possible that your lung problems have been made worse by keeping a parrot. A lung specialist could look at your X-rays and do some blood tests to see if your body is reacting to the parrot.

Have your say: Readers write

RS from Birmingham takes antibiotics before sex to prevent urine infections:

It's not only young children who need to take antibiotics to prevent urine infections. For years, I would get cystitis more or less every time I had sex. I tried everything to prevent it, but in vain. Then a doctor suggested that I take a single dose of antibiotics just before intercourse, or within two hours afterwards. Since then, I have only had cystitis once.

LW, a pharmacist from Nottingham, explains the high cost of emergency contraception:

I sympathise with your reader regarding the cost of Levonelle. It is set high to recompense the pharmacist for the time involved in these sales. It is worth knowing that emergency contraception is available free of charge from many pharmacies when it is supplied under what is known as a "patient group directive". A call to NHS Direct would inform the reader whether such a scheme is available locally, and at which pharmacies.

DJB turned out not to have high blood pressure, despite high readings in the surgery:

I would encourage the reader who wants to reduce his blood pressure to have a 24-hour blood-pressure monitor fitted. Your GP can refer you for this and you shouldn't have to wait long. For me, it showed that my blood pressure was normal for my age, despite two years of high GP readings.

Dr Kavalier regrets that he is unable to respond personally to questions

Send your questions and suggestions to A Question of Health, 'The Independent', Independent House, 191 Marsh Wall, London E14 9RS; fax 020-7005 2182; or e-mail health@independent.co.uk.