I am 42 years old, and often work in the garden and get small nicks on my hands. Is it still necessary to have a tetanus injection? I have never heard of anyone catching this disease. If so, how often should I have a tetanus injection?
Imagine a disease, the seeds of which are in the soil around us. A disease not restricted to the third world nations of Asia and Africa, but present in Australia. A disease that causes the death of nearly half the people who catch it, and which causes excruciating pain from muscle spasms triggered by the slightest noise. A disease that can be caught by having a relatively small cut anywhere on the body. A disease called tetanus.
We are fortunate in Australia to have access to vaccinations which prevent this terrible disease and the number of people who catch it is not therefore high. In less fortunate countries, the population is not as well educated and medical services are not as readily available. Thousands of people die a terrifying and tortured death because of the unavailability of a simple vaccine. Tetanus vaccination is still necessary, and if you have not had one for ten years, you could catch tetanus!
All children should have a series of vaccinations known as triple antigens at two, four, six and eighteen months of age. This contains vaccines against whooping cough and diphtheria as well as tetanus. A further booster is given prior to school entry at five years of age.
Adults are also at risk. The tetanus vaccine does not give life-long protection, and tevaccination is necessary every ten years. If you have a wound likely to be contaminated by tetanus, the vaccination should be given again after only five years. Deep wounds, such as treading on a nail, are particularly likely to cause tetanus.
The tetanus vaccine is one of the smallest and least painful injections of all, and it has no side-effects. There are no excuses for you and your children not being adequately protected. See your general practitioner soon. Tomorrow may be too late!

What can be done to help my wife’s Raynaud’s phenomenon?
Raynaud’s phenomenon is often associated with cold weather, and sufferers should choose the warmest climate possible for their home.
The symptoms occur in the hands and feet and are due to spasm of the small arteries in the extremities. Patients have fingers and/or toes that go red, then white and finally blue, while swelling up and causing considerable pain.
Treatment involves wearing gloves, bathing in warm water, and medication to dilate the arteries. There are a number of drugs that can be used. Nicotinic acid is the one most commonly prescribed, but a drug called Adalat also shows considerable promise. These must be used regularly to prevent the problem, and are only available on prescription. An ointment that is used to dilate heart arteries can also be used in very small amounts on the hands to dilate the arteries in the acute situation.

I have had an operation on the salivary gland under my ear for a tumour, and I have been left with Frey syndrome. If I had known this would happen, I would not have had the operation.
Mixed tumours of the parotid gland, the main gland behind the jaw and under the ear that produces saliva for the mouth, are very sinister growths. Although usually not cancerous initially, they may grow to a very large size to cause disfigurement and pain, and may in time turn malignant.
Once one of these tumours is discovered, removal at the earliest opportunity is sensible. Unfortunately, the facial nerve, which controls the muscles of the face and other nerve fibres (sympathetic and parasympathetic nerves) that control blood vessels and sweat glands, runs through the centre of the gland, and an enlarging tumour may engulf more branches of the nerves, making it very difficult for a surgeon to avoid all the tiny filaments when the tumour is removed.
If the nerve or some of its branches are cut, you will lose the ability to move the facial muscles on one side supplied by those nerves, including those that control the lips.
Frey syndrome occurs when the facial and other nerves to the face are damaged by an infection of, or surgery to, the parotid gland. It results in sweating and flushing of the face, and drooling when eating.
It is very unfortunate that you have developed this syndrome as a complication of the surgery, but without the surgery, your life could be even more miserable with a tennis ball sized mass on the side of your face, and an early death from malignant change.