Doctor's Column: I am a man with one woman-like breast. What should I do?

Dear doctor, I’m a 22-year-old man and something recently developed in one of my breasts. My doctor said it is gynaecomastia and that it will go away, I should be patient with it but I’m worried it might take long and its even making me uncomfortable. Please, I need help on how to get it out in the shortest time possible if there is any, besides waiting.
Amos Opio

Dear Amos, gynaecomastia simply means enlargement of male breasts to look like those of a woman. Whereas some harmless enlargement occurs in boys after birth, at puberty and older men because of a decrease in the male hormone, it usually leads to stress requiring an immediate solution, the very reason you may be complaining about waiting as advised by a doctor.

Adolescent boys can develop gynaecomastia (at around 14 years) affecting one or both breasts, it usually resolves spontaneously which is why your doctor may have told you to wait.

Breast growth is stimulated by the female hormone oestrogen while the male hormone testosterone opposes the growth. So increases in the female hormone and reduction of testosterone may lead to growth of female-like growth of breasts. The sex hormonal increases of puberty may lead to breast growth but once this stabilises, after puberty, the growth stops and the problem resolves. Gynaecomastia may happen with certain medical conditions and may be reversed if caught early, if not, it becomes irreversible.

The male hormone can reduce because of things like castration, kidney failure, liver failure, obesity, drugs for HIV/Aids, hypertension, steroids, cosmetics such as tea trees, therefore resulting in gynaecomastia. In many cases, once the cause is established, proper treatment may resolve the breast problem but in case this does not, then surgery to remove the breasts may be contemplated.

Dear doctor, my saliva stinks, I have had this problem for five years now and tried every medication given but there has not been any change. I have been taking herbal medicines but still there is no change. What can I do to get rid of it?
Ronnie

Dear Ronnie, saliva is made in the salivary glands which pour it out into the mouth. Saliva will stink if one has infection of the salivary glands or a mouth condition like a rotten tooth, inflamed gums or a dirty tongue.

Also, saliva may smell because one has bad breath therefore the causes of this bad breath, which may include inflamed tonsils, sinuses and lung conditions have to be addressed to stem the odour. Practices such as smoking, chewing tobacco and eating foods like garlic may cause saliva odour.

Stinking saliva can lead to stress and anxiety but it is important to brush teeth and the tongue after meals on top of flossing properly to stem it.

Dear doctor, is it advisable to take mumbwa while pregnant. Also, is there anything wrong with washing the stomach because of serious constipation when I’m pregnant?
Yudita Nyabwaana

Dear Yudita, during pregnancy, many factors, like increase in the pregnancy hormone, progesterone (which relaxes muscles like the digestive tract in the body) being picky about food or having food cravings, vomiting, and use of food supplements that contain iron may combine to cause constipation.

And the problem may be compounded later in pregnancy by the pressure of the growing uterus on the rectum. Eating high-fibre foods such as whole-grain cereals, fruits and vegetables, drinking plenty of water, or other fluids (not tea, coffee, or alcohol), and exercising regularly can help. If the antenatal iron supplements you are taking contain lots of iron, an alternative should be sought out.

Washing the stomach may kill natural bacteria in the intestines, bringing in dangerous ones and also introducing toxic substances that may harm the mother and foetus’ health alike.

Mumbwa contains substances that contract the womb and the effects on the baby may be harmful . Therefore this, plus stomach washing should be avoided.

Dear doctor, I tested in April this year and was negative. My girlfriend also tested negative in October. However, I recently got a small swelling on my body, scratched it and saw another one, which had pus coming out of it.
I was very scared and have not told my girlfriend about it because I have not seen anything of the sort on her, and she would have told me if she did. I went to a private clinic and was given some tables but I don't see any change and fear to go for another HIV test because I am in a foreign country and will get deported if it turns out positive. Please advise me. Sometimes I feel my body gets hot, especially at night.
Anonymous

Dear Anonymous, I suppose the test you did was an HIV test. It is commendable that you did this test because many people fear to do one only to live in ignorance about their status.

If you had not been sexually involved three months or more before the test, it is likely that your second test is only a formality and will still be negative and thus you need not fear to do another one.

It is recommended that one does another test at least three months after the first one since one may have a germ in his blood but it has not yet been detected in what is called a window period.

Because HIV infection if not well managed may lead to death, many people will suspect they have the problem with any symptom that takes long to cure. In your case, you seem to have an allergic reaction which means you are over-reacting to a substance you ate, drank or which may have come in contact with your body. The reaction will come back whenever you get exposed to whatever it is, regardless of the treatment given.

Allergies may cause skin swellings which itch and scratching them only worsens them by introducing germs.

HIV infection may cause swellings in its early stages but these are deeper (lymph nodes) and it is unlikely that it could be the cause of your feared symptom. Since you were negative, please make sure you remain so by being faithful and routinely having HIV tests so that you get the courage to remain negative. So go ahead and have another test, ,which I’m sure will be negative.

Dear doctor, explain to me why children get malaria every evening and yet they may play during the day. Do the parasites know it is night when our medical facilities are closed and therefore attack?
Eddy Byankabya

Dear Eddy, malaria is a disease caused by plasmodium parasites acquired from bites of an infected female Anopheles mosquitoes seeking a blood meal to help mature their eggs. The plasmodium parasites include, Falciparum, Ovale, Vivax, Malariae and lately, Knowlesi is causing malaria in Malaysia. The parasites attack our red blood cells and feast on blood cell pigments only for the cells to burst releasing the parasites and debris in blood resulting in fever.

Fortunately, the body clears the mess and the fever wanes, only for the parasites to attack other cells which later burst, causing yet another bout of fever.

Between attacks, therefore, temperature may be normal or even below normal. The fever may reccur in cycles at intervals of 48 hours (in so-called tertian malaria) or 72 hours (quartan malaria), depending on the type of parasites.

So it is not true that the parasites target their victims at a time when the medics are away so that they are not eliminated.

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