A conversation about treatment in Ein-Bokek
Greetings, dear friends! We revisited Ein Bokek and visited the Dead Sea Clinic and interviewed Professor Mikhail Rivkin, M.D., who has been practicing at the resort since 1996. During the interview we learned more about the spa treatment of patients with respiratory, musculoskeletal and skin diseases.
Hello Mikhail, could you please tell us with what diseases patients come to you for treatment?
The main groups of diseases that we specialize in are skin diseases (widespread and focal psoriasis, atopic dermatitis), diseases of the musculoskeletal system (arthritis of different origin, including rheumatoid arthritis, arthrosis, osteochondrosis, hernia) and respiratory diseases (bronchial asthma, chronic recurrent often repeated pneumonia and bronchitis, ENT-illnesses). As in all resorts, we also provide anti-stress therapy for patients with, for example, sleep disorders or neurasthenia.
What treatment methods do you use at the clinic to treat patients with skin diseases?
The main methods of treatment used at the Dead Sea are peloid therapy, sea bathing, thalassotherapy and climatotherapy. The uniqueness of our climate is the low level of ultraviolet radiation. This is due to the fact that the water level of the Dead Sea is 400 meters below sea level, and only ß-radiation reaches here. That is why it is true that it is impossible to get burnt at our resort. In more than 20 years of work, I have not seen a single patient with a tan so strong that he got blisters and bubbles on his skin! You can only get an erythemic dose of sun exposure (reddening of the skin) here. Speaking of the Dead Sea water, I want to note that it is the only one in the world with such a rich mineral composition and high salt content. Therefore, due to the weightlessness experienced by patients during sea bathing, the treatment of diseases of the musculoskeletal system is carried out. In the treatment of the aforementioned diseases we also use local muds in the procedures.
Mikhail, please tell me, what are the benefits of sea bathing and how is this procedure carried out?
During bathing patients lie on their backs, as if experiencing the effect of weightlessness. This effect is due to the high salt content of the Dead Sea, up to 33%. The body weight in the water is only 150-200 grams, due to which not only the musculoskeletal system, but also the whole body is unloaded. We recommend swimming at the Dead Sea 2-3 times a day for no more than 15-20 minutes (15-30 minutes between each bath). After 15-20 minutes of bathing you should take a shower (not necessarily with soap), to wash off the salt from the skin, as it can cause irritation and even scabies or perspiration. By the way, to recreate the water at home with a similar concentration of salt in a bathtub with a capacity of 100 liters of water, you should pour 50 kg of salt.
For patients with respiratory diseases, climatotherapy is also important, right?
Of course, this is the main method of treatment in Ein Bokek. The air here is saturated with minerals, dry and quite clean, as this area of the resort is protected and there are no pollutants. In addition to climatotherapy, we also prescribe a complex of different procedures. To treat psoriasis, we use only natural therapeutic factors; we have many ointments and creams containing minerals from the Dead Sea. We do not prescribe any hormonal drugs to our patients.
What procedures do you prescribe to your patients?
For psoriasis of varying degrees of lesions, we perform a salt peeling - all our patients love this procedure and, moreover, without it we cannot start a treatment with natural factors, as the peeling allows a little cleansing of the skin before sea baths, sun and air baths.
Do you give any recommendations to patients who are going to come to the resort?
For patients with dermatosis, for example, we recommend 1.5-2 months before the treatment at the resort to reduce the dose of hormonal drugs taken or, if possible, exclude them altogether, as it is contraindicated to combine them with phototherapy. However, abrupt withdrawal from hormonal preparations that the patient has been taking for a long time may, on the contrary, stimulate the development of psoriasis and it will be very difficult to achieve remission in 2-3 weeks. That is why it is better to reduce the dose gradually, or take other drugs that replace steroids, as recommended by your doctor. We do not recommend coming to the spa for patients with rheumatic diseases in the active phase.
The use of natural healing factors, of course, involves seasonality, especially for a seaside resort. What recommendations in this case can you give to patients with different groups of diseases?
Patients with comorbidities, such as high blood pressure, should not come to our sanatorium treatment in the period from June to early September. If the patient has psoriasis - on the contrary, it is better to come in summer. January and February can be an exception, because the maximum temperature in these months may fall to +20 °C, minimum - up to +15 °C. Water in the sea in these months, of course, is not as warm, but patients can visit the pools with heated water of the Dead Sea, they are in every hotel in Ein Bokek. But in general, the resort is considered a year-round with individual restrictions. The climate of our resort assumes a large number of sunny days, it almost never rains. In the spring, summer and autumn it is hot here, so you should always wear a hat to avoid heat stroke. Since the climate here is dry, you should drink up to 3 liters of water per day. Considering that we inhale dry air and exhale humid air, it is noted that vacationers at the Dead Sea lose 1 liter of water per day through breathing alone.
Mikhail, could you tell us about the therapeutic procedures at the Dead Sea Clinic?
Our clinic provides patients with about 100 types of medical procedures: thalassotherapy, physiotherapy, different types of massage, medical and cosmetic procedures and many others. Our doctors also provide our patients with consultations. As for procedures, I want to note that one of the most necessary in the treatment of skin diseases is insolation, when patients need to sunbathe in the sun without clothes. Our clinic is located on the Dead Sea coast in the "Solarium" building, which has an open area divided into two sectors so that men and women can sunbathe there separately and then go for sea bathing afterwards.
Tell me, are there any contraindications to visiting the resort, in addition to the general?
The only contraindications I can mention are myocardial infarction and hemorrhagic stroke. Patients with such disorders can come for treatment in Ein Bokek (and in principle to change the climatic zone of stay) not earlier than 6 months after the diseases. This should be borne in mind and people with hypertension, but still always better to consult your doctor. Patients who have had cancer, can come to the Dead Sea after a few years, and also on the referral of the doctor. However, given the fact that there is no harsh spectrum of solar radiation at the resort, metered sea bathing and insolation (if you sit in the shade) will not cause any harm. Contraindications are also thyroid diseases, hyperthyroidism and hypothyroidism.
We do not recommend bringing children under the age of 6 to the resort, as the Dead Sea water can have a negative effect on their body. I would also like to point out that the Dead Sea water is intended for external use only, our resort does not provide treatment of gastrointestinal diseases with mineral waters, as other resorts do. A stay at our resort is conditionally indicated for patients with endocrine and gynecological diseases.
Do patients with gynecological diseases come to Ein Bokek for treatment?
Yes, but if patients have benign tumors in the pelvic area, then we do not recommend that they receive excessive insolation and, all the more so, mud procedures.
What medical documents should be brought and is it possible to be examined directly at the resort in case of their absence? Perhaps you cooperate with some laboratories?
As a rule it is a spa-resort card with the results of all the necessary tests, information about how the patient's previous treatment was and the recommendations of the attending or family doctor. If the patient has not been examined at home, we can perform the necessary laboratory tests at the spa for an additional fee.
It is known that psoriasis and atopic dermatitis often affect children. Could you tell me, please, whether children can get any treatments at your clinic?
Absolutely. From 6 years old we prescribe dermatological procedures, therapeutic massage, thalassotherapy, as well as physiotherapy and mud procedures with restrictions.
Are there any recommendations for patients with spinal disorders such as osteochondrosis, hernia?
For such patients we recommend to bring the results of CT and MRI to the resort, on the basis of which we will prescribe treatment.
Mikhail, please tell me, please, what doctors of what specialties work in your clinic?
We have a dermatologist, a physiotherapist, an orthopedist, a general practitioner, and if possible we also invite a nutritionist. We have a highly qualified osteopath, who is a teacher of osteopathy in Israel, he consults patients, conducts osteopathic correction of the spine, as well as the procedure "dry traction of the spine" (cervical, thoracic and lumbar spine) for patients with scoliosis, protrusions and prolapsed discs, herniated discs.
Can you tell us how dry traction of the spine is performed?
The procedure is performed in the following way: the patient lies on the couch, where the thoracic and lumbar spine are fixed in a certain way using equipment connected to a special computer. The computer specifies individual parameters of the patient's spine and the computer automatically draws the patient's spine. The course of treatment includes 10-12 such procedures lasting 25-30 minutes, the procedure is absolutely painless. After extension of the spine patient can go to other procedures or sea bathing, there are no restrictions.
Could you tell us more about your dermatologist, please? We know that this specialist has over 40 years of experience.
Our dermatologist has been working at the Dead Sea Clinic for more than 15 years and is a professional in her field: she examines patients, gives them recommendations, conducts phototherapy and PUVA therapy (without the use of chemicals). Since psoriasis patients may come to us for treatment in winter, in order for them to get the right dose of sun exposure, we prescribe them both PUVA therapy with ultraviolet radiation of a certain spectrum and insolation.
Could you tell me what period of spa treatment is considered the most optimal?
Patients with sleep disorders, for example, who come to Ein Bokek to rest, a week's stay at the resort will be enough, and those who have chronic diseases, such as psoriasis, - from two weeks to a month, as it is impossible to achieve purification and recovery of the skin in just one week. Patients with respiratory and musculoskeletal diseases are recommended to be treated for three weeks. You should realize that the generally accepted optimal period of treatment of 21-24 days was not established in vain, because during this period it is possible to achieve remission of chronic diseases for at least six months or a year. To get the best effect of spa treatment, we recommend coming to the Dead Sea 2-4 times a year.
