Q: My husband is unable to exercise regularly because of work pressures. So he walks 50km on Saturdays and Sundays. I think this is harmful. Please advise.
A: Your husband is part of a new 21st century phenomenon the weekend warrior who works hard all week and then decides to cram the entire minimum fitness requirement (180 minutes a week) into two days. Though this is not really advisable, it is better than being a full time slug. Some precautions have to be taken though, like warming up and cooling down to prevent injuring unconditioned muscles, tendons and joints with unexpected over activity.
Q: My daughter has vitiligo (leukoderma). I was advised to give her milk from a black goat without boiling. Is this safe?
A: Goats milk is preferred over cows milk in many parts of the world for children who are artificially fed. Its composition is similar to that of human milk. It contains less fat than cows milk and is, therefore, more easily digestible. However, there is no conclusive evidence that it has any beneficial effects in vitiligo. The composition of milk does not vary depending on the colour of the goat. Raw milk (not boiled or pasteurised) can contain bacteria and cause disease. The common bacteria transmitted through raw milk (cows or goats) are salmonella, campylobacter, E. coli, toxoplasma and brucella. All these can cause fever and diarrhoea.
Fibroids & cancer
Q: I have painful and heavy periods. The doctor says I have two fibroids but that no treatment is required as they are harmless. I am worried about cancer.
A: Fibroids occur during the reproductive phase of a womans life. They are usually harmless. They may delay conception or cause miscarriages. Periods may become prolonged, painful and irregular. Most of these symptoms can be tackled with medication. Problems can arise if the fibroid degenerates or outgrows its blood supply. If and when complications set in, surgery or some other intervention may be required. Fibroids are not cancerous, nor do they evolve into cancer.
Q: I have polycystic ovarian syndrome (PCOS) and have been placed on metformin. I think it is a medication used for diabetes. My blood sugar is normal. Should I take the medication?
A: Women who suffer from PCOS generally have insulin resistance even when their blood sugar levels are normal. Metformin has been proven to improve ovulation and reduce androgen (male hormone) levels. Overall, when used in conjunction with the other medication (hormones) that you have been prescribed, it enhances their effect.
My chemist treats me
Q: I find that my local pharmacy gives me a better deal than my doctor. The doctor wants tests and then I never recover for at least two days. If I tell my pharmacist my problem he promptly hands over some tablets and my recovery is immediate.
A: It sounds like your pharmacist is practising shotgun therapy where he gives you a mixture of medication for any ailment. He may even be adding a steroid. The response will be immediate. Unfortunately, at any time you might receive inappropriate treatment, precipitating a medical crisis or a serious drug reaction. In all matters it may be better to search for expert advice from a qualified person, rather than relying on someone who has learned through experience alone.
Q: After reaching menopause, I had some uncomfortable symptoms and my doctor put me on pills for hormone replacement. Later they were stopped because of dangerous side effects. I have vaginal dryness and was given oestrogen cream for regular use. Is this dangerous too?
A: Oestrogen creams have a local action and are useful for vaginal dryness. Like any other medication, you should follow the doctors recommended dosage regimen and go for regular check-ups. After menopause, taking calcium supplements and maintaining muscle strength with regular exercise are also important.
Q: My son had seizures with fever at the age of one and now we are very worried.
A: Seizures with fever (febrile seizures) can occur in children without any brain infection. Unfortunately, they can recur if the temperature rises. Children usually outgrow them by the age of three years. Regular anti seizure medication is not needed unless the seizures have occurred more than three times. As soon as your son has fever, give him paracetamol (15mg/kg/ dose), remove his clothes, place him under a fan and sponge him with tepid water. Carry paracetamol with you when you travel. This will lower the temperature as soon as it begins to rise and prevent seizures.
Q: My son has a foot deformity and has been given special shoes. He does not like to wear it and prefers to go barefoot.
A: You have not specified the type of deformity. In general, if corrective shoes have been given, they should be used.
Dr Gita Mathai is a paediatrician with a family practice at Vellore. Questions on health issues may be emailed to her at firstname.lastname@example.org