Can you explain what happens in mammography? My doctor has suggested I have this done, but it scares me.
Mammography is merely an X-ray of the breasts, and there is no reason for concern. During the procedure, the breasts will be X-rayed from top to bottom and side to side. There may be some discomfort as your breasts are squeezed between the X-ray plates, but it only takes a few seconds, and the results can be life-saving.
There are now many doctors who believe that all women of 40 years should have a routine mammogram, and this should be repeated every five years. Combined with monthly breast self-examination, mammography is an extremely effective way of detecting breast cancer at an early stage. Women are now having tiny breast cancers removed, without disfiguring scarring, before they or their doctor can feel any lump or discomfort.
Early detection is the key to successful cancer treatment, and if you are concerned about your breasts, or if there is a family history of breast cancer, do not hesitate to have a mammogram arranged by your general practitioner.

I have an X-ray request slip from my doctor to have an air-contrast barium enema done. What will happen to me?
This is an X-ray that shows the lower part of the gut from the anus up to the appendix, and sometimes the last part of the small intestine. This part of the gut is about one and a half metres long in an adult.
The day before the X-ray, you will have to use special medicines to clean out all the faeces from the gut. When you go to the radiologist’s rooms, you will be undressed and lie on your side on a rather narrow table. A small tube will be placed in your back passage, and through this a mixture of barium will be run into the large gut. You may be given injections in the arm to relax you and the gut during the procedure.
You will be rolled around from side to side while X-rays are taken, and air will be introduced into the gut to display any abnormalities more readily. The procedure may be a little uncomfortable when your gut is inflated with air, but this settles rapidly.
After half to one hour, all the pictures necessary will have been taken, and you will be asked to go to the toilet to pass the barium mixture that was previously introduced. Your bowel function will return to normal after a couple of days.
The procedure can diagnose most diseases of the lower gut, and will only be requested if your doctor considers there are good reasons for doing it.

My wife’s general practitioner and psychiatrist believe that she is manic depressive, but her sister has talked her out of taking any medications as she does not believe in doctors or medication. She now refuses to see her doctors and I am having great difficulty in coping with her wild mood swings and neglect of our children.
Manic depression, or a bipolar personality, can affect anyone in the community. It causes patients to have episodes of severe depression when they may feel suicidal, and at another time they may be excessively happy and do things they may later regret. These swings in mood may occur every hour or two, or may be weeks apart. In a depressed mood the patient will be withdrawn, sleep poorly, loose interest in work and friends, and appear generally gloomy. When manic they may spend excessive amounts of money, take outrageous risks, become sexually promiscuous or party till dawn.
Women are far more likely to be affected than men.
Medication can be used to reduce the highs and lows so that the patient has normal mood swings, without stopping them from being the person that you know and love. A bipolar personality is no different to any other chronic disease that requires long-term medication. In the same way that people with high blood pressure, diabetes or asthma must take medication on a regular basis to control their condition, so must people with a bipolar personality.
These people cannot pull themselves together without medical help, and unless they do take medication, in one of their extreme mood swings, they may harm themselves permanently. Doctors cannot force patients to take medication, so it is a matter of convincing your wife (and her sister) that she may be better off receiving appropriate medication than taking risks with her life and damaging the lives of her family.

A friend of mine has an overwhelming fear of contamination and spends hours a day washing his hands and taking showers to the point where he cannot work. What can be done to help him?
I am very concerned that your friend suffers from an obsessional neurosis. This is a psychiatric condition that requires treatment by a supportive specialist psychiatrist as soon as possible. The longer it is left before appropriate treatment is commenced, the harder successful treatment will become.
The first step is to take your friend to his family doctor, using a pretext if necessary to get him to attend. It is often worthwhile warning the doctor beforehand about your concerns. Hopefully the GP will be able to convince him to accept referral on to the psychiatrist. Further treatment will involve the use of medications, psychotherapy (analysis to find out why he has these fears) and behavioural therapy (training him to avoid the compulsive behaviour) to rid him of his unreasonable fears and his compulsion to wash himself.
It will take several months, and possibly years, to control the problem adequately. Some patients tequire continuing management by doctors for the rest of their lives.