Thursday July 14 2011

Why does my body temperature rise in the morning and evening?

Dear doctor,
When I wake up in the morning, I feel my temperature is high, sometimes one side is warmer than the other. In the evenings, my temperature is so high that I feel like I have a fever.

Dear Anonymous,
Taken from the armpit using a thermometer, human temperature is averagely 37 degrees centigrade. A higher temperature may indicate a fever. A fever is one way our bodies try to fight germs but a fever can also occur when tissue is destroyed or even due to some cancers. Usually when one has a fever, he may feel hot.

In most cases, when the temperature rises even when it is higher than average normal, one may instead feel cold. They later feel warm when a certain set temperature is reached. One may feel hot if exposed to warmer external temperatures like a hot sun or due to physical exercise but this is not fever. In Uganda when a person feels warm, sweats, or even gets a headache, he will say he has a temperature or fever due to malaria. He then takes an antimalarial as if he is antimalarial deficient. This has largely caused antimalarial resistance.

It is true that in some people especially children, having a fever may make some parts of the body feel cold and others like the head warm. When measured, the temperature of some parts of the body like the anus is higher than others like the armpit. However, feeling warmer on one side than the other is likely to indicate anxiety or stress. That said, you need a thorough investigation of your symptoms which could have other causes including infections.

Dear doctor,
My friend develops black small patches around her private parts. When she goes to the health centre, they say it is no big deal and yet the patches seem to be slowly increasing in number. They are like “ensundo”. I am just wondering what may be the cause. Thanks and hope to receive a reply.

Dear Anonymous,
Black patches on the pubis that do not worry medics may be part of the so-called pimples that strike those in puberty but in some people may persist well into the forties. Though pimples affect the face, they may also affect the inside of ears, the back, chest and genital area.

When pimples heal, areas of scars or dark spots may be left behind. The pimples affecting the pubis due to sweat may form fluid filled areas called cysts which apart from being black may be swollen. Pimples are not infectious and will go away with time even without treatment and therefore need not stress you.
You, however, need to visit your doctor again and tell him/her of your concerns so that he/she rules out conditions like venereal warts and hypertrophic scars that also look like your condition.

Dear doctor,
I am a 38-year-old married man married to a 27-year- old woman. Before my wife delivered, we were both asked to test for HIV. She tested positive and I, negative. We were both counselled and advised to use condoms. She delivered a negative baby who has been screened for three years and always tests negative. For a year now, we have not been using condoms though we were told to do so by our doctor. This was because we both wanted to have another child. She has conceived twice and gotten miscarriages. She believes she’s being bewitched. Is that true doctor?

What perturbs me is that whenever we have sex, I see a whitish discharge from her private parts which always itches both of us. Doctor, doesn’t that itching affect the baby inside her? Last week I went for an HIV test and was still negative. Is it possible for me to still be negative when I have had unprotected sex with her for three years? Please doctor advise,

Dear Moses
It is possible for you to be negative after encounters with a woman who has HIV infection. When you have had many sexual encounters with a positive partner and continue to be negative, it is referred to as HIV discordancy. In this kind of sexual relationship, you are likely to get infected if you continue having unprotected sex. That is why your doctor advised you to use condoms which unfortunately will not give you a baby.

An HIV positive woman can give birth to an HIV negative child. With medical supervision, the risk of infection or the woman getting complications are reduced. However, as your woman’s disease progresses, it is possible for you to get another child who may be infected.

Anyone in a discordant relationship should consult with his doctor for proper advice, the moment he feels like getting a baby. The fact that you went ahead with unprotected sex to get a baby shows that you did not consult with your doctor because you knew it at the back of your mind that he would advise you against it. I am sorry to say that the HIV infection could be the cause of the miscarriages. This is why you need to consult with the doctor to get proper treatment and more advice on how to prevent them as well as avoid infecting yourself. Whitish vaginal discharge that itches both of you may be due to Candida infection common in many Ugandan women without any known sickness or those with diabetes, HIV and pregnancy.

Dear doctor,
Is it true that persistent flatulence results into irritable bowel syndrome and is the later curable? I used a laxative to flash my system but ever since that time, my bowel movements make a lot of noise. Is it the laxative which initiated the bowel movements or it is gas?
Nkambo S. Munkaaga.

Dear Nkambo,
Flatulence is excessive gas in the abdomen. This may result from many causes including diet (vegetable salads, dairy products, beans and carbonated drinks like sodas),gall stones, peptic ulcers, stress, constipation and drugs.

Irritable bowel syndrome (IBS) on the other hand involves chronic abdominal pain with changes in bowel habits like flatulence, bloating, diarrhoea, and constipation. The symptoms come and go but it may be worse after a meal or when one is stressed. It may be relieved by a long call.

Too much tummy gas and diarrhoea can cause abdominal grumbling. Laxatives may cause diarrhoea but IBS can also lead to diarrhoea. Lifestyle changes including exercise and avoiding foods that worsen symptoms may be helpful in IBS. Using laxatives anyhow without a doctors prescription is likely to worsen problems alternating diarrhoea and constipation.