Thanks for the question, Joanna. Every year around this time, when it gets hot and humid with lots of rain and mosquitoes multiply, this question comes up -- particularly from runners who spend lots of time running on trails. Time for the answer…

You are correct!

While a natural reaction to a mosquito bite is a small bump and itching, there is an “allergy” described in the medical literature to mosquito bites. It is called “Skeeter Syndrome.” Hallmarks are fever and extreme inflammation around the bite: redness, swelling, and of course itching. I have even seen patients with one bite causing multiple red blotches all over their body. You can go to an allergist for a scratch test for mosquito bite allergy to confirm your allergy.

Prevention is obvious: stay away from the critters! Wear protective clothing (long sleeves, long pants) whenever possible, and use an insect repellent with DEET in it. Do not scratch the bite -- as you note, doing so can cause an infection on top of the natural inflammation of the bite.

Treatment is usually with a cream like hydrocortisone or Caladryl lotion directly on the bite. Systemic medications like Benadryl, Zyrtec, or Claritin have also calmed down allergic reaction to bites.

If any of my readers have some home remedies for these bites, please write in for Joanna. I am sure she would like to see them.

I hope this helps.

Enjoy the ride.

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Oh, Jenny, I feel your pain. In fact, this is the most common question I get at the medical information booth at marathons: “My doctor says I can’t run. Can I run?”

Running on stress fractures, in general, is very risky. What can happen is that they break through into a full fracture of the bone, thereby elongating the recovery period. The best rule of thumb is that if you can run with your normal form, you can continue to run. But if your pain causes a change in form, it is time to stop.

Femoral neck stress fractures are the most dangerous to run on. Should they break all the way through, you would need a hip operation and sometimes screws or even (worst-case scenario) an artificial hip. The fact that your physician said not to run is probably good advice until you're healed.

Some physicians allow for pool running on stress fractures. With a femoral neck stress, this just doesn’t work because the muscles attached to this area continue to pull on the bone and not allow the bone to heal.

So, Jenny, I am sorry to give you the bad news, but your doctor is right. Please follow his advice. Coincidentally, the only patient still in the hospital after last month's Seattle Rock ‘n’ Roll Marathon is a young woman about your age who didn’t listen to her doctor and ran with the same stress fracture. She is scheduled for a hip replacement this week! When you're shopping for a second (or third!) opinion that you want to hear, realize that that opinion may not be the most learned.

Please let us know how your recovery goes.

Enjoy the ride.

Have a question for the Running Doc? E-mail him. NOTE: Due to the volume of mail, we regret that the Doc cannot answer every e-mail.

Dear readers,

I just returned from the inaugural Seattle Rock ‘n’ Roll Marathon and Half Marathon and thought you might like to know what I saw from my medical perspective at the med tent and expo of this exciting event.

With 25,000 participants and a huge, two-day health and fitness expo, this event was amazing. Thanks to all my readers who came to my seminars and to the medical information booth.

A few interesting questions I got at the expo:

"Is it really going to be 70 degrees? That’s warm!"
True, 70 degrees is not ideal for most marathoners. But it's not warm enough to institute our "heat plan," and doesn't increase heat-related complaints at med stations, in my experience. In Seattle, many runners just did not feel prepared to race in 70-degree temps. However, everyone did well. Pre-race jitters!

"How bad are the hills?"
Actually the course was pretty flat, and participants thought it was fast and beautiful along the water.

"Why 37 waves at the start?"
The course was narrower at the beginning than most races and having the waves gave people ample elbow room.

Notes from race day:

• From my Medical Control bunker we followed all medical incidents. Nothing unexpected was seen, and no heat-related illness even though some runners worried they weren't prepared to run a marathon in 70-degree temperatures.

• In order to best spot problems, medical personnel were on bikes -- one per wave. In addition, we had golf carts with medical people every half-mile and medical stations every mile. I had 500 medical volunteers from all institutions in the Seattle community and they all had a great time helping everyone finish the race.

• Participants all did very well with minimal injuries, considering the size of the crowd. The usual blisters and strains but nothing serious.

• The raves from this fist-time event were a pleasure to hear. Elija Nyabuti won the half-marathon in 1:05:14, the fastest half-marathon in state history. (The previous record of 1:05:43 was set in 1994.) Nyabuti actually finished his race before that last wave had even crossed the start line.

Overall: What a great first-time race. Great weather, great course, great city! The best complement I heard was from someone who said it seemed like the race had been there forever. Thanks, everybody, for your support.

If you ran the half or full marathon, please let me know what you thought. We can always get better and your comments are a help.

Enjoy the ride.

Have a question for the Running Doc? E-mail him. NOTE: Due to the volume of mail, we regret that the Doc cannot answer every e-mail.