Q: I went to see a doctor and the visit made me very tense. He checked my blood pressure and it was 180/90. He asked me to come again after three days. This time it was 200/90. I am 24 years old and I don’t think I have high blood pressure. The sight of the doctor’s clinic gives me a panic attack and, I suspect, pushes up my blood pressure.

A:You may have “white coat hypertension” a condition where the blood pressure goes up on seeing the doctor or the BP apparatus. Since hypertension (high blood pressure) is a silent killer, you need to have the problem sorted out.

Ask your doctor to fit you with a 24 hour monitoring device. That will provide a conclusive answer as to whether you have hypertension or not. If you do, then it needs to be figured out why you developed hypertension at such a young age, and if the cause is correctable.

Stretch marks

Q: I have stretch marks on my underarms, shoulders, groin, lower abdomen and thighs. Due to this I feel hesitant to go swimming. Also, these areas itch uncontrollably even when I am in a public place. I am forced to locate the nearest restroom to scratch. I am 180cm tall and weigh 100kg.

A:Your maximum permissible weight is 80kg. At 100kg, you are overweight. As you gain weight, the elastic fibres under your skin get stretched. Micro “breaks” occur in them and as these heal, small scars are formed leading, eventually, to the formation of visible lines under the skin, the stretch marks.

You need to lose weight with diet and exercise. With diet alone, in addition to the stretch marks, your skin will develop a sagging appearance. Every day before a bath, massage your skin with a mixture of equal quantities of coconut oil and sesame oil. Wait for 10 minutes and then bathe. Apply clotrimazole powder after a bath to the itchy areas. If the sensation is still severe, you may need to take a mild non-sedating antihistamine.

Chronic gout

Q: I developed pain in my left knee and, despite treatment and physiotherapy, the relief was erratic. I got my uric acid values checked and as they were found to be high, I took the results to my orthopaedic and he started me on medications for a month, after which I was better. After six months, the symptoms recurred. I am worried that I have chronic gout and want to know if there are any dietary restrictions I can follow.

A:Gout is a genetic condition where uric acid produced in the body gets deposited in the joints causing pain. Tablets can control the symptoms. With the newer medications, dietary restrictions are not as important as they were a century ago. Certain medications, such as aspirin and diuretics, can aggravate gout. These may be essential for other concomitant diseases like heart problems and therefore need to be continued. Alcohol, and caffeine containing drinks can also cause subtle dehydration elevating uric acid levels. Certain food like fish, meat, peas, beans, cauliflower and lentils can also push up uric acid levels.

Dr Gita Mathai is a paediatrician with a family practice at Vellore. Questions on health issues may be emailed to her at yourhealthgm@yahoo.co.in