Some Medical Questions and Answers by Dr.Gita Mathai

Q: I am 61 years old and have a fine tremor in both my hands. The doctor says it is not Parkinson’s disease. I drink 16-20 cups of tea a day and smoke 20 cigarettes.

A: The caffeine in tea can aggravate an underlying tremor as can the nicotine in cigarettes. Try to stop both. If there is no improvement in two weeks, please consult a neurologist. You might be suffering from an underlying “essential tremor,” which is being aggravated by the tea and cigarettes.

Bleeding gums:-

Q: My gums bleed, even if I don’t touch or irritate them in any way. What should I do?

Bleeding from the gums usually follows a mild infection called gingivitis. This may be the result of a build up of tartar and plaque formation. The gums may also bleed owing to Vitamin C or K deficiency, or a reduction in the number of platelets in the blood. Or it could be part of an inherited bleeding or clotting disorder. Treatment with anti-coagulants may cause blood to ooze from the gums. Consult a dentist at the earliest.

Breast problem:-

Q: I am a 16-year-old boy with well-developed breasts. I feel very self-conscious as boys often make fun of me. Please advise.

A: Enlarged breasts (gynaecomastia) are an embarrassing part of adolescence in many boys. About 90 per cent of them recover spontaneously. Overall obesity can give a false appearance of enlarged breasts. Losing weight with diet and exercise will correct this. The condition may be a side effect of medications, especially steroids. Liver diseases can also cause gynaecomastia. It may also be due to an abnormal genetic make up or syndromes such as Kleinfelter’s, though this is rare. You need a complete evaluation by a physician who will be able to tell you if the breasts are normal or if further tests are required. The eventual treatment depends on the final diagnosis.

Cancer survival:-

Q: My grandmother, her sister and my mother all had cancer of the breast. I read about genes being involved in this disease and decided to have a mammogram. The doctors found a small cancer and removed it. What are my chances of survival?

Survival in breast cancer is not dependent on the genetic make up. Carriers of the BRAC1 and BRAC 2 genes are more prone to developing cancers of the breast and ovaries, but their survival rate is the same as that of other suffers who do not carry the genes. Follow your doctor’s advice regarding surgery, medication and follow-up visits. Also, maintain a healthy lifestyle with a balanced diet and exercise. Women who exercise regularly cope better, physically and mentally, with cancer.

Painful period:-

Q: I am a 34-year-old woman with two children. I never had any problem with my periods; they were painless and always on schedule. Of late, however, the cycle has become irregular. The bleeding is heavy with clots and I also have severe pain in the stomach, back and legs. What should I do?

A: Pain associated with periods is called dysmenorrhoea. Some women have pain from the time they first start menstruating. In your case, the pain is a recent phenomenon and is also associated with a change in the type and duration of the cycles. This needs evaluation. A gynaecologist will be able to tell you the reason for the changes after a pelvic examination complemented with an ultrasound. If there is a disease process, treating it will cure the pain. If there is no correctable reason, judicious use of painkillers like paracetamol or mefenemic acid will help.

Breathe easy:-

Q: I have asthma and use inhalers regularly. I am symptom free most of the time. How can I improve my health?

A: Asthma is often precipitated by triggers. The common ones are cigarette smoke, mosquito repellents, agarbattis and room fresheners. All these are best avoided. The frequency, duration and intensity of the attacks can be reduced by breathing exercises. These involve deep breathing with a focus on the coordination between the muscles (diaphragm and intercostals) used while breathing. They can be learnt from yoga classes or from a physiotherapist. If you do not have access to either, there are sites on the Internet that demonstrate the exercises.

My daughter’s constipated

Q: My two-year-old daughter has been constipated from the age of two months. She passes motion with difficulty after four or five days and sometimes even a week. We have tried eliminating milk from her diet and also force her to eat three bananas a day. All this, however, has not helped.

A: Your daughter needs to be evaluated by a paediatrician to see if there is any correctable cause for the constipation. Is there a thyroid problem or liver disease? Or is there some other abnormality in the gastrointestinal tract such as Hirshsprung’s disease?

If all the above are normal, the retention of stool may be voluntary and because of a failure in toilet learning. Normally, when an infant senses the need for bowel movement, he or she relaxes the buttocks and increases abdominal pressure. Functional faecal retention begins when the child fears bowel movement. This could be because the act hurt on some occasion. The child’s bottom then subconsciously starts to contract instead of relaxing, as he or she attempts to avoid bowel movement. The inside walls of the colon stretch to accommodate the contents and the urge to defecate passes, leading to chronic constipation.

Source: The Telegraph (Kolkata, India)

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