DEAR DR. DONOHUE: Will you tell me the best way to treat pet bites? I have three young children, and we live in a neighborhood where every family except us has at least one pet. Most are dogs. I don’t want to overreact to a tiny scratch, but I need to know what to do with a more serious bite. — A.M.
ANSWER: I’m limiting my remarks to cat and dog bites. Wild-animal bites require more involved treatment and are best taken care of in a hospital setting.
A domesticated animal that has bitten a child or adult should be observed for 10 days to see if it exhibits signs of rabies. The threat of rabies is small, but maximal precautions have to be taken because rabies is such a deadly illness. Unprovoked bites from an animal raise the suspicion of rabies.
Less-serious bites, the ones that can be treated at home, are copiously irrigated with sterile saltwater. Not many homes have sterile saltwater, so the bite should be washed with soap and water and then irrigated with tap water. After the irrigation, apply a disinfectant like Betadine (povidone iodine). Inspect the wound daily for any signs of infection — skin redness or pus. If you see those signs, take the child to a doctor.
If the child’s immunizations are up to date, all is well. If they are not, he or she needs a tetanus booster. If the child has had no tetanus immunizations, the series should begin right away.
Wounds that are large, that bleed, that are quite deep or are in a place, like the face, where they might be deforming should be taken care of by a professional.
DEAR DR. DONOHUE: I’m in my 60s and never had a major illness. I take no medicines. In the past three months, I have been wakened from sleep with a dull pain in the center of my chest. My husband told me to take Mylanta. I did, and got instant relief. What do you think of this pain? — V.P.
ANSWER: Pain that wakens a person from sleep must be taken seriously and ought to be reported to the family doctor.
However, the response you got from taking Mylanta (an antacid) makes me think of GERD — gastroesophageal reflux disease, more commonly known as heartburn. Stomach acid and digestive juices spurt into the esophagus, a structure not equipped to deal with them like the stomach can. If this nighttime pain of yours keeps coming back, put 6-inch blocks under the bedposts at the head of your bed to keep stomach juices in the stomach when you lie down.
My first statement about nighttime pain has to be observed. You need to see the family doctor to be certain this is heartburn and not one of the many other serious possibilities.
The booklet on coronary artery disease, another cause of chest pain, details its signs and symptoms. To obtain a copy, write: Dr. Donohue — No. 101W, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6 Canada with the recipient’s printed name and address. Please allow four weeks for delivery.
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 32853-6475.
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