A Question of Health

'I was stung by three wasps and each sting swelled up to the size of a plate'
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Wasp worry

Wasp worry

Q. I react badly to insect bites and stings. A horse-fly bite will spread steadily over two days until it covers the whole of my thigh or lower leg. The swollen area is dark red, almost liver-coloured, and hot to the touch. The advice given by a practice nurse is to elevate the limb and apply ice, but this treatment is not successful, and the bite area remains swollen and the discolouration lasts several weeks. When I was aged one, and then when I was 21, I was stung by wasps and had a mild reaction. When I was 32 I was stung by three wasps simultaneously and each sting spread rapidly to become the size of a plate. I was given antibiotics and Piriton and told to seek medical advice immediately the next time I was stung. Three years ago I was stung again and the local A&E department gave me Piriton and steroids. The sting did not spread and I suffered no discomfort. I had an IgE (allergy) test and was told that I had "only localised reactions" and was "at low risk of having a systemic reaction". Then last summer I was stung on my upper arm, and the bite spread quickly from shoulder to elbow. My doctor is at loss, and I am concerned, as each reaction is worse than the last.

A. I can understand your worry - I too would be worried if my whole arm swelled up each time I had an insect bite. Allergy specialists categorise the reaction to insect bites as either local or systemic. Local means that the reaction is confined to the site of the bite (although this may mean quite a wide area). Systemic means that other parts of the body are affected, such as the throat, the tongue and even the heart and circulatory system. Systemic reactions are considered much more serious, because they can be fatal. But local reactions can still be very unpleasant and painful. It sounds as though the only time you managed to survive a bite without a serious reaction was the time that you were given steroids in the A&E department. These are very effective in suppressing the body's immunological reaction: it's not the bite itself that is causing your problem - it's the way your body reacts (or over-reacts) to it. At the very least I would suggest that you use a strong steroid cream as soon as you are bitten. Another option would be to have an emergency supply of steroid tablets. I suspect that if you took a short sharp dose of steroids (40 mg prednisolone) as soon as you were bitten, you would be much less likely to react so severely.

Burning feet

Q. For three years I have had a burning sensation on the soles of my feet. Also, although I can feel it if I pinch my feet, there is a certain numbness. I have asked my doctor about this but he just smiles and looks at me as if I am slightly dotty. Over three years the burning and slightly dead feeling has increased slightly. I know my circulation isn't good, as I get chilblains when the weather gets cold. But I exercise regularly. Should I worry? Is there anything to alleviate these symptoms?"

A. I'm not sure why your doctor looks at you as if you are slightly dotty. The symptoms of burning and numbness of the feet are absolutely typical of a peripheral neuropathy. This is condition in which the nerves that connect the brain to the rest of the body are damaged. There are many causes of peripheral neuropathy, and I'm sure you need to have a few tests to try and find out why your nerves are not working properly. Diabetes is a common cause of peripheral neuropathy, and it can also be caused by vitamin B12 deficiency and excessive alcohol intake. Tell your doctor to take your symptoms more seriously.

Adult bed-wetting

Q. Sometimes when I've spent the night drinking I wet the bed. This is something that has started over the last few years; it was never a problem before. Why doesn't it happen every time, even when the amounts I consume are similar? Why are heavier drinkers not affected? Any suggestions for a cure?

A. Bed-wetting in adults is more common that anyone is prepared to admit. If you have recently started wetting the bed you need to have some investigations to try and find out why. If you collapse into bed dead drunk, it may be that you are virtually unconscious when your bladder is trying to tell you that it wants to be emptied. But the problem could also be caused by bladder problems, kidney problems, or even hormonal problems. Diuretics (water tablets), can also cause bed-wetting in adults. Talk to your doctor about it.

HAVE YOUR SAY: READERS WRITE

JT offers an alternative explanation for headaches on aeroplanes:

Could the woman with the migraines while flying in fact be suffering from nasal congestion which does not allow air at ground pressure to escape while in flight? My family suffers from migraines, and while flying we have found that decongestants work well.

Many readers have written in with suggestions about how to treat dry, itchy skin that is worse in the winter. The most popular treatment by far is simple Vaseline. MB from London says: "It's a soothing ointment that is effective within half an hour and the itching stops for some days." CG says: "I have found that just three or four drops of olive oil in the bath water has a noticeably soothing effect on the skin (and remarkably little adheres to the bath itself)."

Send your questions and suggestions to A Question of Health, 'The Independent', 191 Marsh Wall, London E14 9RS; fax 020-7005 2182; or e-mail health@independent.co.uk. Dr Kavalier regrets that he is unable to respond personally to questions

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