Q: I work on the computer all day and develop a terrible headache by evening. I have had an eye check up and an MRI (magnetic resonance imaging) scan. Both are normal.
- A: Computer furniture has to be ergonomically designed so that the screen, keyboard and chair are aligned correctly and placed at the correct height. The chair should be adjusted so that the eyes are on level with the screen. Also, the glare of the screen should be reduced with an antiglare filter or spectacles.
If the room is air-conditioned, take steam inhalations morning and evening to reduce nasal congestion. Try to do head and neck exercises morning and evening to reduce strain and tension in the muscles. Also, jog 40 minutes in the morning before going to work.
Q: I have a shooting pain down my left arm. I thought it was a heart problem but the doctor said the ECG and other tests were normal. I then took an X-ray. It was diagnosed as a cervical rib. What should I do?
A: Ribs normally arise from the vertebrae in the chest. However, in 0.5 per cent of people, partial ribs arise from the neck vertebrae. These are called cervical ribs. They are usually asymptomatic and discovered incidentally on a routine X-ray. They cause symptoms if they compress nerves and blood vessels going to the arm. This can occur in middle age as a result of weight gain, poor posture or decreased muscle tone.
Physiotherapy is usually all that is required. If the pain is severe and intractable, surgery may be advised.
Q: My son has started to develop boils all over his arms and legs. They are painful and when they burst yellow pus oozes out.
A: These superficial skin boils are usually due to a bacterium called Staphylococcus, which lives harmlessly on the skin of most people. Sometimes it manages to get a foothold in the skin (usually at the site of mild trauma), producing recurrent boils.
Your son needs a scrub bath with a medicated soap like Neko applied with a plastic or natural scrubber twice a day. No talcum powder should be used. Apply Neosporin skin cream or Mupirocin ointment.
Q: My three-year-old daughter always has a runny nose. She also has a frequent cough. After a course of antibiotics for three or five days, she is better. But the cycle repeats within a few days. Could it be primary complex?
A: Primary complex classically causes failure to thrive. In short, the child fails to gain weight and may actually lose weight instead. Also, fever is present everyday, usually at night. Your daughter does not seem to have these symptoms.
The doctor may be prescribing the antibiotics to allay your anxiety. If the child has only a viral infection or an allergic cold, the antibiotics will not help. Check the temperature with a digital thermometer. It should be more than 100.5° F for at least three days before antibiotics are begun.
If your child has recently started school, you can expect six to eight colds a year.
It is also possible that she is allergic to something in the house like cigarette smoke, incense or a mosquito repellent.
Q: I find that I cannot lift my right arm. It does not go up more than half way after which I develop severe pain.
A: It sounds like you have adhesive capsulitis or frozen shoulder. It occurs usually in middle age, as a result of injury or diabetes. Sometimes it can occur without any apparent reason. Treatment is with painkillers and physiotherapy. Rarely, surgery may be required.
Q: My tonsils are very large and they seem to have yellow dots. I am 35 years old. Do I need to have them removed?
A: Tonsils usually become smaller as people grow older. They are rarely troublesome after the age of 20 years. You need to consider surgery only if they are an obstruction to swallowing, or become infected, and cause pain and fever five or six times a year.
The yellow dots may be food particles stuck in the crypts of the tonsil. Perhaps if you gargle with salt water they may disappear.
Q: My two-year-old son falls forwards for no reason at all. This occurs several times a day, even while he is sitting.
A: Children sometimes develop partial seizures with the movements you are describing. Its very much a treatable condition. Consult a paediatrican who may order tests like an electroencephalogram (EEG) and a brain scan. You may be referred to a neurologist.
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