Q: My one-year-old son developed watery diarrhoea. We went to several doctors who first prescribed tests and then gave him antibiotics. Eventually I was told he had developed milk intolerance and was switched to soya milk. Can I give him goat or buffalo milk? Can I use a tinned product like Nan or Lactogen instead?
A: Your son has developed an inability to digest lactose, the sugar in milk, probably as a consequence of gastroenteritis. Since he is a year old, and you do not want to give him soya milk, try keeping him on other foods (no milk) for 72 hours. Very often the intestine recovers its ability to digest milk in that time. Nan, Lactogen, goat and buffalo milk all contain lactose. Switching him to these products will not solve the problem.
Q: My daughter is 24 years old and has been diagnosed with lung cancer. How is it possible? She does not smoke.
A: The factors that contribute to the development of lung cancer in non-smoking women are postulated to be exposure to second hand smoke, high levels of the hormone estrogen, genetic factors, or abnormal embryonic remnants in the lung that mutate. None of these (except exposure to second hand smoke) can be changed.
Sugar or honey?
Q: I am diabetic, but my blood sugar level is well under control. I use Equal in my tea and coffee. Recently I read that it is bad for health. Can I use honey instead?
A: Honey contains fructose, glucose and sucrose. All these are sugars, so substituting honey for sugar will not help. The main constituent of Equal is aspartame (L-aspartyl-L-phenylalanyl-methyl-ester) which is about 200 times as sweet as sugar with virtually no calories. This compound breaks down in the system to:
1) Phenylalanine (50 per cent), which can be neurotoxic and in some susceptible people cause seizures
2) Aspartic acid (40 per cent), which can cause brain damage in the developing brain
3) Methanol (10 per cent), which turns into formaldehyde
The quantities taken by diabetic patients in tea and coffee are small and probably insufficient to cause these adverse reactions. People who drink large quantities of diet cola or such drinks are more likely to be affected. The reactions are idiosyncratic and vary from individual to individual.
Q: I gained 4 kg after I got married. This now makes me 75 kg. Also, I have not been able to conceive.
A: Your lifestyle may have changed after marriage. The best thing to do is to stop snacking, cut out chocolates and puddings, and always refuse a second helping. You also need to exercise. An hour a day is sufficient, but you need to vigorously cross train. Run one day, swim the next and cycle the third. Combine this with yoga if you want that hourglass figure.
Q: My nine-year-old son still wets his bed. This is an embarrassment to us.
A: Bed wetting is said to be primary when bladder control has never been achieved and secondary when there is a reversion to it after six dry months. Most children achieve night time bladder control by the age of three. But around 30 per cent of children continue to wet their bed. Even without treatment, this percentage falls to 20 per cent by the age of six. However, one per cent of adolescents continue to wet their bed. Bed wetting may be familial and is commoner in boys. If urine and blood test results are normal, and there is no structural abnormality, then the outlook for such children is good. About 15 per cent gets spontaneously cured. Berating the child, punishment or humiliation is not an answer to the problem.
A few simple measures may help:
* Limit fluid intake after 7pm
* Avoid caffeinated drinks (colas, tea and coffee)
* Encourage the child to go to the toilet before bedtime
* Avoid punishment
* Encourage success
* Leave a light on in the bathroom
* Make the child wear simple underclothes without complicated bows and zippers so that they can be easily pulled up or down if required.
Gasping for air
Q: I have been diagnosed with emphysema. I am breathless most of the time. How did I get this?
A: Emphysema usually follows lung damage as a result of long-term cigarette smoking, air pollution or occupational exposure to dust as in the case of coal miners. It runs in some families where many members have a genetically determined deficiency of an enzyme called Alpha-1-antitrypsin. It can occur in poorly controlled asthmatics. Lung function decreases with age so it can occur in older people without any of these risk factors. It is also commoner in men.
It can be treated with inhalers, nebulisers, oxygen, bronchodilators and appropriate antibiotics whenever an infection flares up. In the case of smokers, treatment will not succeed unless smoking is stopped.
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