Q: My father cannot walk more than a few metres before his legs start to ache. If he stops and rests for a few minutes, he is able to walk again, only to have the whole cycle repeated.
A: Your description of your father’s problem sounds like peripheral arterial disease, a condition where the arteries to the legs are partially narrowed and blocked owing to the deposition of fat plaques. This occurs with diabetes, hypertension and also if cholesterol and triglycerides levels are elevated. This results in effort intolerance.
Get your father thoroughly checked. If biochemical abnormalities are found and corrected, it may cure the symptom. You can also do a Doppler test to find the location of a block. Consult a vascular surgeon. He might recommend arterial stents or bypass surgery.
Meanwhile, by continuing to walk, he probably can gradually increase the distance covered.
Q: I am 24 and have burning pains in my chest at night. It has been diagnosed as Gerd (gastro oesophageal reflux disease). I am on 40mg of pantoprazole daily for the last two years. The discomfort does not occur if I take the medication. Last month I was diagnosed as anaemic though I am a non-vegetarian and eat well.
A: Pantoprazole is a medication that falls into the group of “proton pump inhibitors”. Long term use affects the absorption of the B complex group of vitamins, calcium and iron. This can result in anaemia. Pantoprazole is usually given for the shortest possible duration to relieve symptoms. A normal course lasts 8-10 weeks. You seem to be taking it for a long time. You should check with your doctor.
Q: My wife likes to drink 2-3 cups of coffee a day. She is now pregnant and was advised not to drink coffee. She feels miserable.
A: The offending ingredient in coffee is caffeine. A cup of coffee can contain anything between 70-100mg of caffeine. There have been studies associating low birth weight babies with mothers who have 150mg of caffeine a day and miscarriages in those who have greater than 300mg a day.
Perhaps it makes sense to avoid coffee. After all, a pregnancy is not a permanent state. It does not last longer than 10 months; so why take a chance?
Q: My right hand shakes whenever I try to do something. I am afraid I have Parkinson’s disease. Are there any confirmatory tests?
A: The tremor in Parkinson’s disease is fairly typical and is called a “pill rolling movement”. There are also other signs like an expressionless face, rigid limbs and a shuffling gait.
The diagnosis is mainly clinical. There are no confirmatory tests.
You need to consult a neurologist. They will make the diagnosis.
Q: I want to lose weight. Each time I write to you, you advice diet and exercise. This seems to be a slow and inefficient way to lose weight. Aren’t there any medications?
A: Everyone is looking for a “quick fix”. There are other ways. You could opt for surgery but it is a major procedure, has side effects and — here is the bad news — even though surgery helps lose weight drastically, to keep the weight off permanently you need to stick to a strict diet and exercise regimen.
There are some medications that can be prescribed for losing weight; some of them are appetite suppressants, others are bulking agents or prevent fat absorption. Again they cannot be taken indefinitely, have side effects and need to be combined with diet and exercise. So any which way, there's no escaping diet and exercise.
Q: My husband smokes outside the house and comes in reeking of cigarette smoke. I have two small children and recently I noticed that one of them coughs whenever my husband enters the room.
A: Second hand smoke contains a mixture of fine particles and 7000 + chemicals, 70 per cent of which can eventually cause cancer. In children it also can cause ear infections, sneezing, coughing, wheezing and bronchitis.
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