Thursday April 11 2013

DOCTOR’S COLUMN: Can a person have sex when asleep and not know about it?

Dear doctor,

 

By Vincent Karuhanga

Dear doctor, in Arua, a priest slept with a woman and made her pregnant. The woman was banished because it was believed that she bewitched the priest to sleep with her unknowingly. The bishop accepted the priest’s version of the story. Can anyone sleep with a woman and not remember?

Jacob Amandua, Arua

Dear Jacob, it is true that a man with many sexual partners may not remember some of them. If the priest does not have many sexual partners and actually had coitus with this woman, this may be one of the few stories of a medical condition of sleep sex (sexsomnia).

Abnormal or unnatural behaviours during sleep are called parasomnias. In some documented circumstances, women or men have undressed their sexual counterparts and even put condoms on themselves or on the men while in their sleep before having sex with them.

Just like in sleepwalking, night dancing and sleep eating, either a woman or a man can have sex while asleep and not be aware of it. Just like sleepwalking, sexsomnia may start early in childhood and continue into adulthood.

People with parasomnias are thought to be bewitched or even attacked by demons requiring exorcism or prayer and yet this is a recognised medical condition. That the bishop believed the priest but not the woman may indicate that the bishop may have been aware such a problem exists and as such gave the priest the benefit of doubt to the priest. A DNA test may be necessary for paternity but will not rule out sexsomnia.

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Dear doctor, acid was thrown at me by thugs two years ago but the attack was not bad though I now have scars, which I want removed. Where can I do this?

Immaculate

Dear Immaculate, acid burn injuries represent a special kind of injury, with the effects depending on the type of acid, concentration, strength, quality, duration of contact, and penetration power. In Uganda, the common causative agent is sulphuric acid, which is used in batteries.

The face and neck are mainly targeted for maximum psychological torture. When the airway is involved, there may be death due to breathing problems. It is likely you developed bad scars called keloids which may require a plastic surgeon, who you can get from big hospitals like Mulago hospital.

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Dear doctor, people say that bazungu doctors cannot treat etalo, which is said to result from witchcraft. As such, it requires an “African solution”. Are there recent advances in medicine to treat this?

Nike Sserumaga

Dear Nike, the skin is the largest organ of the body and it helps protect the inside from germs and therefore body infection. Sometimes, the skin gets breaches some of which we can see with our naked eyes (wounds) but some are too small to see (microscopic).

Yet for germs, which we cannot see, these are large enough for entry of billions of them leading to infection of the skin and tissues (the dermis and subcutaneous tissues). This is what is called cellulitis, or locally, etalo.

Because of absence of a visible wound in most cases, the route of infection seems bizarre and creates a notion of witchcraft and therefore incurable by conventional medicine.
The main bacteria responsible for the invasion are Streptococci and Staphylococci, with the latter being mostly resistant to many penicillin antibiotics.

This increases the feeling that drugs given by conventional doctors cannot treat etalo.
This infection spreads fast since the spaces under the skin are open and have less blood to bring in the body’s soldiers (white blood cells) and equipment (antibodies) to fight the germs. The affected part swells and there is a fever, sweating, pain and enlarged lymph nodes.

Cellulitis may occur anywhere on the body but the lower leg is the most common site of the infection, given activities like cultivation in the fields that risk the leg injuries. People with diabetes, HIV and obesity, the elderly, and those with infections like athletes’ foot are likely to get it.

Cellulitis can be prevented by proper hygiene, putting on protective wear, treating chronic swelling of tissues (oedema), and care of wounds or cuts though this may be difficult with microscopic breaks in the skin.

Anybody with the problem needs to visit a health centre for treatment as quickly as possible to avoid complications. There are strong antibiotic injections that can be given to cure the condition.

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Dear doctor, when I eat eggs these days, my stomach makes bubbling sounds, I feel full the whole day and pass smelly gas. I am giving up eggs yet I do not also drink milk. Is there anything I can do?

Forward Opolot, Entebbe

Dear Forward, signs such as bubbling sounds in the stomach, smelly gas and bloating that makes one feel satisfied show that you may have egg intolerance. The intolerance is due to failure to properly digest egg proteins which are fed on by bacteria in the large intestines.
This results in foul (rotten egg) gas and substances that may cause foul diarrhoea. Other symptoms like itchy skin rash, shortness of breath, chest pain, sinus congestion, runny nose or sneezing indicate egg protein allergy.

Egg intolerance can be checked by reducing the amount of eggs you eat but an allergy will still lead to problems even when small quantities are taken. It is unfortunate that you also have problems with milk, which shows that you have difficulty digesting milk (lactose) because of lack of or little lactase enzyme.

Please take few quantities of both foods instead of giving them up all together because you may miss out on their important nutrients. If even these cause problems, you may have allergies and intolerance for both of them.

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Dear doctor, I heard on radio that I can take sugar provided it is prepared with the tea instead of adding it on the table but you scoffed at that. Recently, another doctor said honey in tea is fine even if one is diabetic. So, I have started taking honey in tea. Is it okay?

Dammalie Nalumansi

Dear Dammalie, a sugar called glucose is like petrol is to a car, useful for energy and thus, is tightly maintained within a narrow margin by body mechanisms. When we eat food which releases glucose on digestion, the body produces appropriate amounts of insulin from the pancreas to make sure the blood glucose levels are maintained at a normal level.

Diabetes mellitus is a disorder where blood sugar levels are abnormally high because the body does not produce enough insulin to meet its needs or when the body cannot effectively use the insulin it produces.

Therefore, the primary aim of treatment is to maintain the normal blood sugar levels. This can be done by regulating intake of foods that quickly flood the blood with glucose when eaten in preference for those that gradually do so or in minimal amounts.

To properly manage diabetes, direct sugars like sugar in tea, or wheat products which quickly flood blood with sugar, should either be minimised or avoided altogether. Table sugar is called sucrose and is digested in the intestines into small sugars called glucose and fructose for easy absorption into our bodies.

Honey gets its sweetness from fructose and glucose. It is therefore not suitable for diabetics unless they are treating drug-induced low sugar called hypoglycemia. Please visit a doctor for further information but avoid taking in lots of sugar through honey.

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