Q: When I walk I feel I as if I'll fall (I have not actually fallen yet). I cannot feel my feet (especially on uneven surfaces). I live in constant fear of falling. The room spins around me when I get up from bed. My CT scan was normal as were my vitamin D3 and B12 levels. However an X-ray of the neck showed severe cervical spondylitis.

A:Many people with cervical spondylitis do well by avoiding the use of a pillow to sleep, and wearing a collar during the day. Exercises for the neck will also help. A physiotherapist will be able to guide you.

Until the muscles of the neck are strengthened with exercise you might want to take medication so that you do not fall down. Your physician will be able to guide you.

Pills in pregnancy

Q: My wife has been prescribed metronidazole three times a day for 10 days. As she is three months pregnant we decided not to take the tablets but we did not tell the doctor our decision.

A:The use of many medications in pregnancy is controversial. In the case of metronidazole it is mutagenic (causes changes in the cell DNA) in bacteria and carcinogenic (cancer causing) in mice. In humans there have been a few cases of midline defects such as cleft lip and palate.

You have to

• Ask your physician what the diagnosis is.

• Whether the benefit of taking the drug at this stage of pregnancy outweighs the risk to the baby.

• Any medicine in pregnancy is to be used with caution. It is better to wait till delivery for treatment, if possible.

To eat or not

Q: I read a lot of articles about food and exercise. Some articles advice a light snack before exercise while others feel that exercise is better done on an empty stomach. There seems to be no consensus and this is confusing.

A:If you can exercise on an empty stomach then that is all right. If you feel lightheaded, weak or giddy then it is best to have a banana before working out. Some people like to have a cup of tea or coffee before exercising. The caffeine probably helps them to kick-start the regimen. You could carry water and a banana with you while exercising. If you prefer exercising during the day, make sure to schedule it at least two hours after a meal.

Smelly feet

Q: I have to wear closed leather shoes to work. As soon as I remove my shoes, a musty, unpleasant odour fills the room. I find it quite embarrassing.

A:Smelly feet (medical term bromohidrosis) is a problem that people who wear shoes all day may face. As the feet sweat, the moisture seeps into the inner sole. Bacteria act on the sweat breaking it down into malodorous compounds. Shoes take 24 hours to dry out completely, so if they are worn again the next day, bacteria thrive and proliferate in the damp environment.

To tackle this problem, wash your feet with an antibacterial soap such as Neko and use a fresh pair of cotton socks daily. You can also apply deodorant to the soles of your feet. The best thing would be to buy another pair of work shoes and alternate wearing the two pairs so that the shoes have time to dry out.

Size matters

Q: My son is now 14 years old. He developed intestinal obstruction at the age of six. He was operated on and parts of his intestine and duodenum were removed. He now goes to the toilet 5-6 times a day and has barely gained 3kg since then. He is also anaemic and has weak bones. He is short, thin, spindly and unhealthy looking.

A:Once the intestines are damaged or removed, absorption of nutrients, essential vitamins and minerals becomes a problem. This results in loss of weight, weak bones and anaemia. Since there is not enough intestinal length to digest or absorb the nutrients they remain unabsorbed in the intestine and there is osmotic diarrhoea.

Your physician can advise you about further treatment but a few simple solutions are

• Eat easily digested rice-based food, avoid wheat.

• Eat several small meals a day instead of three large ones.

• Avoid milk.

• Artificially supply the digestive enzymes through capsules taken along with meals.

• Take supplements of vitamins like D3, folic acid and B12 along with other water and fat soluble vitamins

• Take supplements of iron, zinc and calcium.

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