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FAQs on General Health

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I've been having a constant pain in my both my heels for over a year. The company doctor gave some medication (cataflam) saying it is tendonitis. Recently, my left heel became more painful to the point of limping. What is the problem?

Your doctor is probably right. The heels are where the Achille's tendons of the calf muscles attach to. Any strenuous activity can cause inflammation and hence tendonitis. If it is very severe, you may have torn your tendons and hence, surgery would be needed. But you would have known at the instant it happened, for example, when you were jumping down from a high place, because of the searing pain and the inability to walk properly after that.

Otherwise, treat with ice packs, compression with ankle guards and give your heels plenty of rest. Medication from your doctor helps to relieve pain and swelling.

Does consuming doxycycline help in acne problems? Doxycycline does not seem to be working well for me. Is there any other stronger medication that a polyclinic doctor can prescribe?

Doxcycline is the standard antibiotic used. You will not see the effects so soon. It takes at least 6 weeks before you see less pimples appearing. There are retin-A creams or antibiotic gel/solution (Erythromycin or clindamycin). If you are not improving, ask the doctor to refer you to National Skin Centre.

I have got bad acne problems and there are acne scars left behind on my skin. What should I do?

There is nothing much you can do about scarring. However, if you are still having pimples with pus, you should see a doctor and be on a long-term course of antibiotics that should be taken on a daily basis.

I am only 25 years old, yet I am developing a circle of bald patch at the back of my head. Has this got anything to do with my hair-washing habits?

If you are male, you could be suffering from early male pattern baldness (MPB), which typically affects the back of the scalp and the front corners above the temples. It is possible to start balding as early as 25. In this case, the only shampoo you may want to try should contain Minoxidil, an ingredient that stimulates hair growth. And you may want to see your doctor who can prescribe Propecia, a hormonal pill that helps to restore hair growth in MPB.

Another rather common cause of painless hair loss is alopecia areata, an autoimmune disorder (due to genetics) where the body starts rejecting scalp hair. Steroid injections and creams given by a doctor may help.

Other causes of hair loss would be serious diseases such as other autoimmune diseases, blood poisoning cases and drug reactions that would need hospitalisation and blood tests for diagnosis and treatment.

Is there any way to get rid the body odour?

Yes. Products like "Rexona" and "Fa" are effective. Besides using such products, remember to bathe at least twice a day and wear light, comfortable cotton clothes.

How can I lower my cholesterol level?

You can lower your cholesterol level by being more physically active. Exercise vigorously 30 minutes each time at least three times a week. Lose weight if you are overweight and follow a low-saturated fat, low-cholesterol diet.

Eat more fibre which is found in fruits, vegetables, legumes and whole grains. Eat at least two pieces of fresh fruit, two servings of vegetables and three servings of whole grains every day. Try to incorporate legumes at least twice each week. Oats, legumes and fruits that contain pectin (citrus fruit, apples and grapes) all help to lower cholesterol because of their soluble fibre content. Use monounsaturated fats in cooking. The two primary sources of monounsaturated fats are olive oil and canola oil. Fish, especially cold-water ocean fish such as mackerel, blue fin tuna and salmon, contain omega-three fatty acids that help lower cholesterol. However, remember not to eat these fishes fried or dipped in butter. Also, do eat at least 25 grams of soy protein every day to help lower cholesterol levels. Choose whole soy foods such as tofu, tempeh or soymilk, or look for foods that have added soy protein.

I am suffering from constipation. I have tried a high-fibre diet but it did not help. Do laxatives have any side effects in the long term?

With a high-fibre diet, you need to take more fluids. You should also exercise as this helps with the mobility of the intestines. Laxatives and enemas (injections of fluid) artificially stimulate nerve endings in the large bowel (colon). The colon is one of the last structures in the digestive tract. By the time food arrives there, nothing is left but indigestible fibre and other non-nutritive material. Laxatives remove lots of water from the colon as well as food residue. If the person refuses to drink liquids, they risk dehydration which can lead to fainting spells and, in some cases, death.

I have constipation. Sometimes I find blood when I clean the area and sometimes there is blood in the stools. What's happening?

Constipated stool can cause slight bleeding. If you suffer from haemorrhoids (painfully swollen blood vessels near the anus) or piles, the bleeding could be much more. If the blood is fresh, you should see a doctor to exclude polyp (small lump that grows in the body), haemorrhoids and other growths in the colon, especially if you have other symptoms like loss of weight and more bleeding than usual.

What are the side effects of taking laxatives?

Taking laxatives daily can upset your electrolyte balance. Electrolytes are minerals like sodium, potassium that are dissolved in the blood and other body fluids. If the electrolyte balance is disrupted, problems like muscle cramps, tremors, spasms, irregular heartbeat, and in some cases, cardiac arrest will occur. The heart stops, and unless the person receives immediate emergency medical treatment, he or she can die.

Laxatives also remove needed fluid from the body. The resulting dehydration can lead to tremors, weakness, blurry vision, fainting spells, kidney damage, and in some cases death. Severe dehydration requires medical treatment. Drinking fluid may not hydrate cells and tissues quickly enough to prevent organ damage or death.

In addition, laxatives irritate intestinal nerve endings, which in turn stimulate muscle contractions that move the irritant through the gut and out of the body. After a while the nerve endings no longer respond to stimulation. The person must now take greater and greater amounts of laxatives to produce bowel movements. He or she has become laxative dependent and without them may not have any bowel movements at all.

Laxatives strip away protective mucus that lines the colon too, leaving it vulnerable to infection. Instead of laxatives, take natural fibre in the form of a drink e.g fybrogel, metamucil or mucofalk. They contain natural fibre from wheat.

10.

I have dandruff. Every time I scratch my scalp, there will be some flakes falling off my scalp. I tried to use anti-dandruff shampoo but once I stopped using it, there were more flakes. What should I do?

Try Selenium sulphide marketed as Selsun. Use it every other day till the dandruff disappears. Pour onto your hand and massage it onto the scalp. Leave it for three to four minutes then shampoo it off with normal plain shampoo.

11.

What is dermabrasion?

Dermabrasion helps to "refinish" the skin's top layers through a method of controlled surgical scraping. The treatments soften the sharp edges of surface irregularities, giving the skin a smoother appearance. Dermabrasion is most often used to improve the look of facial skin scarred by accidents or previous surgery, or to smooth out fine facial wrinkles, such as those around the mouth.

12.

What kind of food and beverage should I avoid when I have gastric pain?

Try to avoid hot, spicy food, alcohol and smoking as they tend to irritate the stomach. The cause of the gastric pain must be determined. It could be due to side effects of drugs or gastritis or gastric ulcer which may be due to a bacterium called Helicobacter Pylori.

13.

My stomach is always gassy after eating. What types of food are prone to producing gas?

Food that contain indigestible substances such as beans and some high-fibre food are prone to producing gas. Since they can't be digested by the enzymes, the indigested food passes to the large intestine where it is acted upon by gas-forming bacteria. Also, take care to avoid any food that in your experience gives you a gassy stomach.

14.

I have frequent headaches even when I am relaxing. Why?

90% of the headaches are due to tension, migraine and cluster headaches, instead of other underlying medical conditions. It would be in your best interests to have your doctor check your health. You should also get your eyes examined as some headaches are caused by vision problems.

15.

How can heart attacks be avoided or reduced? What are the likely factors that can cause heart attacks?

You can reduce your risk of getting heart attacks by living a healthy lifestyle which should start from childhood by:

Maintaining a healthy weight
Not smoking
Eating a healthy balanced diet with less salt and lots of fruits & vegetables for fibre
Exercising
Reducing stress level

By living a healthy lifestyle, you should be a healthy normal adult with no risk of getting heart attacks. If you have high blood pressure, it must be treated and maintained at normal levels. If you are diabetic, your blood sugars should be controlled at normal levels. High blood pressure and diabetes increase the risk of heart attacks.

16.

My right eye is short-sighted while my left eye is not. As a result, I have developed a "lazy eye" syndrome. How can I solve this?

Have your vision corrected by using glasses with the right lens corrected and the left lens at zero or alternatively, use contact lens for the right eye only. If you do not correct your vision, your brain will tell you to use your left eye only and gradually, the vision in your right eye would become worse from lack of use.

17.

I have scars from previous pimple breakouts and these breakouts are getting more and more frequent. Will my skin be cleared of these scars with the help of medication and can the frequency of breakouts be reduced?

If your face is covered with pus-filled pimples most of the time, you need to be on long term oral antibiotics like tetracycline or doxycycline. If it is just monthly small outbreaks, you can get your doctor to prescribe antibiotics (topical erthromycin or clindamycin) for you to apply on your face as soon as it occurs.

Deep scars cannot disappear. They heal, lighten and sometimes, a depression on the skin appears after that. Superficial ones heal with less obvious effects on the skin and can probably be covered with foundation. The important thing is not to let the condition evolve to a stage of pus- filled pimples at which the scarring is deep.

18.

I have been sneezing throughout the day for more than a year. I have tried nose spray, medicine, vitamin and honey (with lemon) but to no avail. What is my problem? What should I do?

You have probably become allergic to something in the air - most likely, house dust mite which is found everywhere. If your sneezing is bad, you can buy some Chlorpheniramine at the pharmacy to stop the sneezing bout. This is not a cure but a relief only. There are no permanent cures at the moment unless the allergen is removed permanently from the air you breathe.

19.

I have sweaty palms, feet and underarms. Will electrolysis help to solve this problem permanently?

Iontophoresis is a method that uses low intensity electric current (15-18 mA), supplied by a D/C generator, and applies it to the palms and/or soles immersed in an electrolyte solution. The procedure has to be repeated regularly, initially in 20 sessions several times a week, gradually spacing out the interval between treatments to one to two weeks. The results vary. Many patients, suffering from light or moderate hyperhidrosis, are happy with the method, while some may consider it too time-consuming or inefficient, and comparably expensive. It is difficult to apply in axillaries and impossible to use to diffuse hyperhidrosis of the face or the trunk or thigh region. If you are interested, this treatment is available at the National Skin Centre.

Another method is sympathectomy, one that interrupts the nerve tracks and nodes (ganglia) which transmit the signals to the sweat glands. Basically, this can be achieved for all locations in the body, but only the nerve nodes responsible for the sweat glands of the palms and the face are accessible without the need for a major surgical procedure. Today, the treatment of choice for moderate to severe palmar and facial hyperhidrosis (but also axillaries, especially if combined with palmar sweating), is a surgical procedure known as Endoscopic Thoracic Sympathectomy. The endoscopic technique is safe, if performed by a surgeon experienced in this type of procedure, and leads to definitive cure in nearly 100% of patients, leaving only a minimal scar in the armpit.

Individuals with combined hyperhidrosis of the palms and soles have a good chance to improve the sweating of their feet after an operation. Isolated plantar hyperhidrosis can, however, only be cured by Lumbar Sympathectomy, an open abdominal procedure.

20.

I have varicose veins and I have just gone for an operation to remove the affected spots. Is it advisable for me to fly now? Am I prone to DVT on flights?

Deep vein thrombosis (DVT) refers to the formation of a thrombus (blood clot) within a deep vein, commonly in the thigh or calf. The blood clot can either partially or completely block the flow of blood in the vein. DVT is more common in the elderly and the very overweight, but healthy young people can develop it as well. Some people are not born with vital blood-thinning substances and are therefore always more susceptible to blood clots. Some medicines, such as the contraceptive pill and HRT, can marginally increase the risk of developing DVT. Although anyone can develop DVT on a flight, certain people are more vulnerable, including pregnant women, people who are overweight, those whose feet do not reach the floor (because the seat puts more pressure on the backs of their legs), the elderly, smokers and those with coronary artery diseases and certain blood conditions.

You have varicose veins which are dilated superficial veins due to faulty valves. Varicose veins generally do not lead to DVT.

When travelling, all should move their legs frequently and contract their calf muscles by moving their ankles in all directions. The thigh muscles should be moved by moving the hips and knee joints.

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