Q: My nose waters all the time. It seems to go drip, drip all day. In between I sneeze non-stop 20-30 times. My nose gets blocked at night and I cannot breathe. This really interferes with my sleep.

A:You need to figure out what you are allergic to. It can be cigarette smoke, vapourising mosquito repellents, room fresheners, agarbattis or cockroach dander. It may even be something you consume every day like milk, or groundnut products. Peanut paste or oil is often used in commercial biscuits and snacks and may be consumed unknowingly. There are centres which perform allergy testing. Get an allergy test done so that you get to know exactly what you are allergic to. Once you cease to have contact with the allergen, the watering and sneezing will disappear.

Until you discover the trigger you can:

Avoid milk

Use a non-absorbed steroid nasal spray like fluticasone twice a day

Take a non-sedating antihistamine at night

Take steam inhalations twice a day

Exercise for 40 minutes.

Tired daughter

Q: My 16-year-old daughter is tired, lethargic and sleepy all the time. She has heavy periods and likes to eat ice.

A:She needs to be evaluated by a physician. She may have a hormonal problem (particularly thyroid), or she may be anaemic. The latter is likely, as eating ice is a form of pica and points to iron deficiency. Once the problem is identified and treated she will recover. To build up stamina and fight tiredness, you need to exercise at least 40 minutes a day.

Neck patch

Q: I have black discolouration all along my neck. Initially I thought it was dirt. I tried to scrub it off with a loofah but it just made my skin raw. I tried to camouflage it with powder but that does not work either.

A:It looks like you have a skin condition called acanthosis nigricans. This can be familial or may be due to one of several medical conditions such as insulin resistance, diabetes or obesity. Please contact your physician to help you with a diagnosis.

The discolouration will not clear up unless the underlying medical condition is treated.

Swim tan

Q: I swim at 7:30 am. The sun is barely up but I get terribly tanned.

A:This is because the droplets of water act as convex lenses, concentrating the sun’s rays. You can apply a waterproof sunscreen with SF (sun filter) 50 half an hour before swimming. Apply it every half hour after that even if you are in the water.

Vitamin D

Q: I read that practically all of India is vitamin D and calcium deficient. How can I correct this without taking supplements?

A:You could try walking in the open from 6:30 to 7:10am, wearing minimal white clothing (at least arms exposed) and without wearing sunscreen. It may help.

Drugs switched

Q: I have been suffering from diabetes for the last 15 years. Even though my sugar levels are now under control, my doctor insists on changing the medication often. This worries me as I keep reading about the side effects of the newer drugs.

A:Unfortunately you are perfectly correct. The newer drugs do seem to have more side effects, which doctors pick up only much later. If you are happy with your medication and the sugar level is under control, request your doctor to allow you to continue with your present drugs.

Winged menace

Q: You keep writing that mosquito repellents are dangerous as they can cause allergies and breathing problems. I live in an area where mosquitoes are truly a menace. I am allergic to bites and scared of the diseases they cause.

A:If only we had more civic sense! Walk around your neighbourhood and see if there are areas of accumulated garbage or stagnant water. Get the garbage cleared and the water drained. If that is not possible, release a few guppies into the water. These fish are hardy, breed prolifically and eat mosquito larvae. Sleep in a mosquito net. Buy an electric bat and kill the mosquitoes in the rooms.

Cat attack

Q: My neighbour’s cat came rushing into our house and bit me.

A:You need to immediately wash the wound. Take an injection of tetanus toxoid. Follow this with the “post exposure prophylaxis” of anti rabies vaccine. This consists of five injections. Even though it is a pet cat there is no guarantee that the cat has received all its anti-rabies injections and that its immunisation schedule is uptodate.

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