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Sun, 22nd July 2018
 

Questions and Answers

 
FOR ARTHRITIS

Q: 

My doctor merely says to take paracetamol for my arthritis, but in this day and age this seems too simple.

A: 

Arthritis which affects vast numbers, and produces pain from mild to severe. Paracetamol 2 x 500 mg after each meal is currently the simplest and safest treatment. Maximum dose is 4 g a day. A vast number of other products have been available since the mid-1950s but most have fallen into disfavour. Side effects, essentially bleeding from the gut and adverse heart issues head the list. Each person is assessed, and an individual management plan worked out. There certainly are other medications. Also, physical methods. Such as physiotherapy, massage, musculo skeletal interventions and exercises, acupuncture, hydrotherapy, and often finally surgery.

 
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AGGRESSIVE DAD

Q: 

My 64 year old dad, retired 4 years, has become very aggressive. He is overly abrasive, abusive, aggressive, especially if one disagrees or criticizes. This is uncharacteristic.

A: 

Medical intervention is essential. He is probably heading for early dementia. There could be a medical reason which may be diagnosed and treated. Sudden uncharacteristic mental behaviour must be taken seriously. Brain cells wearing out, tumours (not necessarily cancer), and various forms of dementia. Alzheimer’s can set in at a relatively early age.

 
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MOPPING FACE

Q: 

I am 65 and eternally mopping my sweating face, even in cool weather. I have tried acupuncture. I am not overweight. It is embarrassing. My husband says my internal thermostat is not working.

A: 

There are vast numbers of sweat glands in the face and scalp. They are under nervous control. With reduced hormonal production, this starts to go crazy. Talk to your GP. It is quite likely that a short course of HT - hormonal therapy - may reduce symptoms. Today this is considered safe for periods up to five years. Some doctors have blood hormonal levels assessed, and prescribe according to these results.

 
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NECK PAIN

Q: 

I suffer from pains in the neck, and my job of sitting all day and working at a keyboard probably does not help.

A: 

The less the muscle fibres are used, the more rigid they become. This leads to spasm, causing pain. Movement of the neck muscles, in as many directions as possible, helps keep them supple and spasm free. Even when sitting, it is possible to spend sixty seconds regularly with various simple stretching exercises. Drink lots of water also to keep fibre well hydrated. Keep a filled glass at your desk to remind you. Avoid fizzy chemical drinks.

 
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UPBRINGING

Q: 

I had a very strict moral upbringing, with sex regarded as immoral and unclean, and sin a grievance of immense proportions. Now I find it hard to get this out of my brain, and often become depressed at my actions.

A: 

This type of upbringing was the norm in the 1800s and 1900s, and only began to change in the latter part of the last century. Parental control and harsh chastising and punishment began to decline. There is no shame in moral values and ethical standards, but to the point of causing stress and depression is no longer acceptable. You need referral to a counselor, psychotherapist or psychiatrist. Otherwise, depression and anxiety may soon become a major issue in your life.

 
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CONSTIPATED KIDS

Q: 

I am a relatively new mum and my child seems to suffer from constipation. Is it OK to give medication?

A: 

Simple measures like prune juice, sieved prunes, sieved paw paw are simple and usually very effective. It takes some time for the intestinal system to adjust to the ways of the world outside the heated swimming pool of a former life. But usually it settles down OK, just as the lungs expand and the heart beats regularly. The body has an enormous capacity to adjust and survive.

 
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MEDICATION MADDENS

Q: 

I have been on medication for anxiety and depression with the new SSRI tablets (says my doctor). However, although I am much less depressed, I find I suddenly flare up in rage if somebody disagrees, even on smaller issues. I am aware of this but cannot control it.

A: 

The SSRIs have certainly made a major positive impact on the management of depressions, adverse side effects are well known. The outbursts you describe not uncommon. Also, in younger persons, there is a well-established increase risk of suicide. Please report this to your doctor. Modification of dose or alternate interventions may be recommended. There is usually a 6-8 week lag between commencement of medication and effect.

 
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DOCTOR OR CHEMIST

Q: 

Everybody develops illness at some stage. What is the best action - see the chemist or go and visit the doctor?

A: 

Many simple illnesses require neither. Viral infections probably head the list, and mild ones are self-curative. A little rest, fluids and probably pain/fever relief will let nature fix you in a few days. But anything that persists for longer may need intervention. The pharmacy is fine for some, but anything that persists or worsens needs GP assessment. Any form of chest pain, especially if sudden needs prompt medical intervention as it may indicate a heart attack. Then get to a public hospital immediately. The triage system will get you to a doctor rapidly.

 
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DOCTOR ON THE PLANE

Q: 

I am a "doctor" but a PhD (academic) kind and not a GP (general practitioner) type. When on a plane I was asked by the hostess to attend a medical emergency. It was very embarrassing when I declined, for it appeared I was shirking my duty to society.

A: 

Make sure your ticket simply refers to you as "Mr" or "Ms" and not "Dr", as they usually do. Advertising what is accepted in society as an invitation to assist when medical help is needed and not a good idea if unable to sustain this perception. A medical doctor has a legal obligation to attend medical emergencies, like it or not.

 
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This health advice is general in nature. You are advised to seek medical attention from your doctor or health care provider for your own specific symptoms and circumstances.

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