DEAR DR. DONOHUE: For three springs in a row, I’ve had poison ivy. I don’t recognize the plant and wouldn’t know what to do if I did recognize it. What exactly should I do? — R.B.
ANSWER: You need to look at pictures of poison ivy and burn those images into your brain. You’ll find books with those pictures in your local library or bookstore. The standard advice is to avoid plants with three leaves on a stem. You need a more exact mental picture.
How avoid it? First, when in an area where you think you might have caught it or when doing chores like weeding, dress protectively by wearing long sleeves, long pants tucked into socks and gloves. The “poison” in poison ivy, poison oak and poison sumac is a substance called urushiol (u-RUE-she-ol). Breaking any part of the plant that oozes sap and even rubbing against the leaves of these plants deposits urushiol on the skin. It causes an allergic reaction. Within four hours to four days after sap lands on skin, the skin reddens and then breaks out in tiny to large blisters. The rash is itchy. Fluid from blisters doesn’t spread the rash.
After exposure, if you work fast, you can prevent the rash from appearing. Wash the skin with soap and water. You don’t have to scrub hard. Doing so irritates the skin. If you wash within 10 minutes of exposure, you’ll be successful. If you wait longer than 30 minutes, you probably won’t be successful. Ointments and lotions like Tecnu Outdoor Skin Cleanser, Ivy Block and Ivy Stat offer protection from the sap contacting the skin. StokoGard Outdoor Cream is another good barrier protector. Wash your clothes, shoes and tools. Sap can coat all of them. Pets can harbor sap on their fur. Give them a bath.
If your skin breaks out, bathing with Aveeno Colloidal Oatmeal controls the itch. So do Calamine lotion and Burow’s solution. Oral antihistamines also are helpful.
If the reaction is widespread and severe, your doctor will prescribe cortisone medicines to control it.
DEAR DR. DONOHUE: Every morning I take my temperature after getting out of bed. It runs around 97.8 (36.4 C). I know it should be 98.6 (37 C). I don’t feel bad, but something must be wrong. What do you think it could be? — T.R.
ANSWER: Put your thermometer back in its container, and don’t take it out again until you feel sick. A surprisingly large number of people are in the habit of taking their temperature daily. It’s not a good habit. It serves no useful purpose.
Body temperature isn’t stuck at 98.6 all 24 hours of the day. It fluctuates. It’s lowest in the early morning and reaches a peak in the later afternoon. Cortisone, which lowers body temperature, is at maximum production in the morning and ebbs in the late afternoon. That’s one explanation for temperature fluctuation.
If you’re active, body temperature rises. If you’re in the cold, it drops slightly.
You’re wasting your time by taking your temperature every day. Stop.
DEAR DR. DONOHUE: Sometimes, when I drifting into sleep, my body shudders. Do you know what I mean? It’s not a painful experience, but I wonder what it means. Is it an indication that something is wrong? — B.K.
ANSWER: That shuddering is called a hypnic jerk. “Hypnic” means “related to sleep.” Just before falling asleep, the brain frequently loses muscle control, and muscles jerk. It’s common and has no significance.
DEAR DR. DONOHUE: I have very large breasts. In view of the fact that so many women get implants, that might not sound like a problem, but it is. I cannot find a bra that supports my breasts, and I believe they’re the reason why my upper back hurts. Can anything be done? — A.M.
ANSWER: Breast-reduction surgery is done all the time. Usually, it’s covered by insurance. You qualify.
Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6