Monday February 24 2014

ASK THE DOCTOR: Why does my child always have cough?



By Vincent Karuhanga

Dear Doctor: My Primary Four seven-year-old son regularly suffers from cough and flu irrespective of the weather. What can I do help him stay safe from this sickness?

Dear Parent: Cough can be a result of the lower air passages getting irritated or clogged especially by mucous. Mucous is produced by the airways to clean up breathed-in air and the air passages. When lots of mucous is produced like during an infection of the airway or an irritation, especially by breathed-in substances, cough comes in handy to remove the excess mucous and avoid interferance with breathing. What you call flu is the excessive production and loss of mucous through the nose most likely caused by the same agent causing cough. Many substances most of which we may not detect in the air we breathe, may irritate the nose and the lower respiratory system causing a runny nose and cough. Sometimes substances may cause cough and a runny nose in one person, and not in others. When this is the case, we call it an overreaction or allergy. It may happen together with reactions in the other parts of the body, especially the skin.
Being unable to detect the allergy triggers, makes it difficult to avoid the substances yet the best way to treat your child is to avoid them.
In case the substances are unknown or difficult to avoid, a doctor prescribes drugs that can help out.
Allergy tests can be done to help one to avoid substances one may be allergic to, meaning that you need to visit your doctor so that he can examine and treat your child further.

Dear Doctor: Every after my periods, I spend a week and start bleeding again. But it is not as much as the menstrual flow. What could be the problem?

Dear Anonymous: The average time a woman takes to have her periods again is about 21 to 35 days. Periods are a normal occurrence in women of child bearing age. Any vaginal bleeding in between periods that is not associated with sex is called inter-menstrual bleeding.
A little bit of bleeding may occur at the time of ovulation because of a fall in female hormones that restore the inner womb membrane after it has been lost due to the previous period. Though this may be scary, it is not usually associated with serious medical issues. Any abnormal bleeding in a woman calls for proper investigations, including a Pap smear to rule out cancer of the cervix. There are, however, many causes of inter-menstrual bleeding including use of contraceptives, infections and fibroids that require ruling out.

Dear Doctor: Whenever I suffer from malaria, my one-year-old also gets malaria. Is it true that it gets it from breastfeeding?
Deborah Naigaga

Dear Deborah: Although malaria transmission usually occurs through the bite of the malaria parasite infected female anopheles mosquito, in a few cases, it can also happen through blood transfusion or it can be transmitted to the foetus from a mother during pregnancy or during delivery. The last two are now rare due to rigorous screening of blood for transfusion, and proper prevention and treatment of malaria in pregnant women.

However, it is not true that a mother can transmit it to her baby during breastfeeding. Mothers who share bedrooms with their babies and both do not use insecticide treated mosquito nets, may get malaria around the same time as their babies. This is because they are both likely to be subjected to mosquito bites at the same time with a likelihood of getting the disease coincidentally, all factors remaining constant.

It is also possible that while breastfeeding your baby, a mosquito can bite you and before having its fill, leave you and also bite the baby. However, it may not release into the baby any, or enough parasites to cause malaria. When a mosquito takes in parasites, they multiply in its stomach and migrate to the salivary glands. From there, they are vomited into a victim during a bite leading to malaria. So even if the mosquito bit the baby after the mother, it will only cause malaria if there were enough parasites left over, after it bit the mother. It is also true that for Ugandans, any fever is taken to be due to malaria. Thus people end up taking drugs for malaria when they do not have it. This is one of the reasons why malaria is becoming resistant to the commonly used drugs.

Also, the fever causing conditions that are usually confused with malaria for instance a cold, can affect a mother and child almost at the same time because they are highly infectious. Insecticide-treated mosquito nets could largely prevent your kind of problem if at all it is malaria and not other conditions that are mistaken for malaria.

Dear Doctor: I was in my periods for a week. However, one week later, I feel like vomiting and also feel weak, which are signs of pregnancy. Do you think I am pregnant?

Dear Selina: Many women, if they were aware of what signs or symptoms of ovulation to look out for, could tell when they are ovulating just by paying attention to their bodies and watching out for fertility signs. This then would be helpful when they want or do not want to get pregnant.

A woman ovulates two weeks to the next period. This means, it is after one has started a period, that she can calculate backwards the day she could have ovulated. The length of the menstrual cycle is averagely 28 days and can be as short as 21 days or as long as 35 days. If you are to use the average, then two weeks after the start of periods is likely to indicate ovulation.

Some women are sensitive to hormonal changes associated with ovulation and they end up not only having headaches but also nausea both (or any) of which can drain one’s energies resulting in feeling weak. It is unlikely you are pregnant. Nausea and weakness can be caused by many conditions. At ovulation time, many women turn horny and may get too much sex, overindulge in alcohol and spend less time sleeping resulting in nausea and feeling weak. The earliest symptom of pregnancy is implantation bleeding which takes place around one week or less to the assumed day of starting of the next period.

Dear Doctor: I am a 25-year-old who was circumcised at 14 years. I have noticed that my manhood has become smaller, and even women tell me so. Is there a way I can make it bigger?
William Masaba, Mbale

Dear William: It is true that circumcision reduces both penile length and size especially when much skin is removed as happens in many traditional circumcisions. Skin contributes to penile size apart from it being more expandable than scar tissue that replaces lost skin. Being less expandable may reduce erect size. The reduction however, is minor and not easily noticed except in circumstances where you compare yourself with other peers.

Also, in many men, when they put on a potbelly, they not only lose the length of the penis which is then taken up by a fatty pubis, but also lose functional length to the potbelly. Unfortunately, this is not helped by looking at one’s penis from the top where the abdomen is obscuring one’s sight requiring standing against and using a mirror which will show the proper length. If you have a potbelly, exercise to reduce the belly and pubis. Exercising will also help you get more stamina and reduce anxiety.

About the women, it is unusual for them to tell a man that he has a small penis. However, many men may be anxious about the size of their penises and anything a woman says may be interpreted to refer to the small size of the manhood.

At 14, the penis is just beginning to grow bigger so I am surprised that it is at this time when you got circumcised that you noticed your penis was growing smaller. This coming at a time of image formation (puberty) means that you probably may be more anxious about your penile size than it being actually small. It is not the dog in the fight but the fight in the dog that matters in sex terms. Penile expansion may damage the erection chambers resulting in erection problems and therefore should not be contemplated.