Monday July 7 2014

Can tuberculosis run in the family?

A health worker looks through blood samples at

A health worker looks through blood samples at a TB laboratory at Mulago hospital. Carrying out skin or blood tests, or an X-ray can tell if you have TB. Photo by Rachel Mabala 

By Vincent Karuhanga

Dear Doctor: My 25-year-old son has Tuberculosis (TB), yet we have never had the disease in our family. And he tells me he has never met anybody with TB.
James Ojok

Dear James: Tuberculosis is an infection, usually of the lungs, which can spread from one person who has the disease to another through coughing, sneezing, singing, laughing or even talking.
This happens when the uninfected person breathes in mucus droplets that contain the germ. Because of taking boiled milk and proper animal health management, tuberculosis of the intestines is now rare.

Healthy people or those who have been immunised usually fight off the germ. But people with diabetes, those living with HIV/Aids, young children, the elderly, or those on medication including those taken for allergy called steroids or cancer may easily succumb.

Many people harbour the TB germ for several years without it causing disease, and when the above factors come into play, a person may fall sick, even without being exposed to the germ.
Also, a person may cough out the germs and if the air is still, a passerby may later breathe in the germ, and fall sick.

Not everyone who coughs, sings or sneezes in another person’s presence has TB, but if they have it, even without the victims knowledge may spread the disease. The TB germs are too small and when they are spreading, a victim may not detect it.
TB is not a genetic disease, but if a member of the family has it, and there is overcrowding in a home among other risk factors, another family member is more likely to get it.

Dear Doctor: My 11-month-old son cannot have an erection. I have tried all tricks such as stimulating his penis or even bringing other babies around and keeping them naked but this has not helped. Do you think he will be able to erect in future?
Dear Antonia: It is common for infants to have an erection when their bladders are full, when passing urine, as they take a bath, get a nappy change, or even for no apparent reason.

Erection, then, is not always necessary and may not happen in many cases, only for it to happen erotically when the child gets older.
Adults get erections when they fantasise, or dream about sex, or from watching sexual parts, scenes or when they are sexually stimulated by touching erotogenic areas on their bodies.

It is not true that infants will get an erection the same way as adults because they are too young to imagine or even know anything about sex. So bringing in naked girl children may not sexually excite your son to cause an erection.
Though erections in infants indicate normal functioning of the nervous system, lack of them does not mean the child has problems with their systems.

If you are concerned, take your child to a paediatrician to check whether there could be a problem, especially of the nervous system.

Dear Doctor: I have a throat congestion that requires me to cough or clear my throat all the time. Doctors have treated me for allergies, excessive stomach acids, bronchitis, sinusitis and postnasal drip, but with no success. Could this be a serious infection or is it one of those conditions that have resisted treatment?

Dear Godfrey: What you call throat congestion can be caused by allergies which may as well affect the nose (allergic rhinitis), the sinuses (sinusitis), throat and the lungs airways (bronchitis).
This, if complicated by regurgitation into the throat by stomach acids can worsen matters, and will require these acids to be controlled before you get better, that is why the doctors addressed all the above.

Acid regurgitation on its own can cause throat and other symptoms, and may also be caused by drugs for allergy such as prednisone.
Allergies make doctors look bad because when the cause is not identifiable, the allergy will strike whenever one is exposed to what they are allergic to.

This is not helped by visiting too many doctors because then, there may be no proper follow up.
It is unlikely that you have a serious infection that requires taking strong antibiotics because even people with allergies end up reacting to antibiotics, which should be taken only on a doctor’s prescription.

Now is your time to visit an ear, nose and throat specialist before you develop a lump in the throat, which is usually due to fear that you could have a serious medical problem including cancer, especially of the throat.

Dear Doctor: My wife is about to leave me because I do not satisfy her in bed. I have trouble erecting after one round of sex. It has happened to me three times now. What should I do? Please help.
Dear Peter: Sex has five consecutive main stages--desire, excitement, plateau, orgasm and resolution.
Resolution is the period following orgasm, when muscles relax to return to normal (to a state before sex).

Immediately after orgasm, men undergo a refractory period, during which erection cannot occur. The duration of this period varies among individuals and increases with age.
Women, however, experience no refractory period getting orgasm after orgasm and thus may feel unsatisfied, especially if you have premature ejaculation as well.
Also, a refractory period may be longer if you actually have sex often, and you are satisfied but engage in sex as an obligation.
What is happening to you is normal and comes with age.

You do not have to get anxious about it since this may in fact affect your performance further.
I do not know whether it is you who feels you do not satisfy your partner, or she tells you so. Every man, once in a while may experience changes in his sexual performance especially related to day-to-day stress, which a counsellor may advise you about when you visit with your wife.