As one of the original professionals to join Health24's online expert service, CyberDoc has answered a large share of over 250 000 questions sent in by our readers to date.
Who is CyberDoc?
CyberDoc is Dr Bets Breedt, a Family Physician, who completed first a BMed Sci and then a MBCHB degree at the University of Pretoria and completed her practical training in Bethlehem in the Free State. After completing her medical degree, Dr Breedt worked at a private practice in Ficksburg for two years where she also did some work as district surgeon.
In 1989, Dr Breedt moved back to Pretoria where she worked as a Senior Medical Officer at Pretoria West Hospital for 4 years and at 1 Military hospital as Departmental Head of the Polyclinic and Hospice for 10 years. She obtained her Masters degree in Family Medicine in 2001.
Since September 2001 Dr Breedt has been working in the Clinical Research Industry and is currently the Director Site Management for an international Clinical Research Organization, she is also a member of the South African Association of Pharmaceutical Physicians and the South African Clinical Research Association.
Here are some of the most frequently-asked questions, and if they don't cover what you need to know, then send your question in to CyberDoc.
Q: Post Nasal Drip
I suffer from post-nasal drip now and then, also sinusitis and allergic rhinitis seasonally. These are mostly brought on by air conditioning at night, or summer pollens, and the problem is not severe, usually clearing up with home herbal remedies.
My problem is that I have a complex that maybe my nose smells from the post-nasal drip? It's just a feeling I have that maybe I can't kiss my partner because my nose or throat may give off an unpleasant odour when I get close to him. Is this possible, and if so, what product can I use to clear this up? Also, I assume if there was a smell, it would only be there when I'm having a bout of post nasal or sinus etc?
A: Infection in the sinuses can cause bad breath. You can rinse your sinuses with salt water twice a day (mix 1 cup luke warm water with 1/2 teaspoon salt). Ask your partner if there is a smell, maybe you are worrying without reason.
I suffer from chronic constipation despite eating foods that are high in fibre, drinking at least 2L of water daily, and taking the 9-strain probiotics. The main problem is that I never feel the urge to go. Sometimes two weeks can go by without having any bowel movement. When I do feel the urge, it's always accompanied by cramps and my stool is always very soft. I also pass a lot of foul gas. I've elimated fresh milk products from my diet and this has helped with the gas, but I'm still constipated.
Laxatives don't help. I've also tried movicol and glycerine suppositories. The movicol didn't help, but I do get some relief from the glycerine suppositories. The problem with the glycerine suppositories is that I get the urge immediately after inserting and can not wait the recommended 15 min because my intestines start to spasm and I suffer from cramps. I also slightly loose feeling in my legs while I have a movement. I'm 24 year old and also suffer from hypothyroidism (I take eltroxin 0.15mg a day). The only time I had a bowel movement almost everyday was when I was being overmedicated for the hypothyroidism(0.2mg eltroxin) and my TSH was 0.013. Please help, I'm tired of being asked if I'm pregnant because I'm so bloated.
A: If you have very soft stools, are bloated, and do not go regularly, you may have a spastic colon. One does not have to have a bowel movement every day - 3 times a week is quite normal. Thyroid hormones play an important role in constipation - are your blood levels normal? It may be worth your while to see a gastroenterologist for some tests (like a barium follow-through) to see if they can find a reason for the bloating and slow bowel action.
I have been off the pill for 3 months, and my skin has been fine, not even a small breakout. At the beginning of the month I started with Centrum Materna (planning to start trying for a baby in two months' time), it's 22 days later, and for the past week. I've such bad acne, even worse than I had when I was a teenager! The break-out is on the left and right side of my chin, and now it's moving up my face... Please help
A: Stop the supplement - it may have something in it that your skin is allergic to. You can just take folic acid supplement for the time being. Try Benzoyl peroxide cream ( e.g Oxy 10) on the spots and ask your doctor for a topical antibiotic lotion like Eryderm.
Q: Blood Pressure
I'm 37, female, experiencing daily headaches and suffering from sinus – I take cetrizine daily. Two weeks ago I went to see my doctor as I was feeling ill. He checked my BP (blood pressure) and it was 140/80. A week later I went back and my BP was 160/90. The doctor gave me Ziak which caused a skin rash and worsened my headaches. I saw another doctor at the same practice and he gave me Prexum plus, but this causes terrible nausea and gives me a heavy feeling in my head. I stopped taking it on Saturday and haven't felt nauseated, and the heaviness in my head has decreased. What do you suggest I do? I don't want to keep going to the same doctor and keep changing medication, especially since I've never had a problem with high BP before. Please advise.
A: Check your blood pressure daily ( at a pharmacy or ask the nurse at your GP) for 7 days, then work out the average reading over 7 days. If the average reading is 140 or more at the top and/or 90 or more at the bottom, you probably need anti-hypertensive treatment. If not, the high readings could have been due to other reasons ( pain, anger, stress and exercise all can cause temporary high blood pressure).
Q: Diabetes test
I would like to know which blood tests I should request to have if I want to know for sure that I don' t have diabetes.
Also must I fast in advance? If so, for how long?
A: You should have a glucose tolerance test done and you should fast from 24h00 until the next morning when you have your test done.
Q: Pain from severed-nerve injury
My dad was been shot in the lower back a few years ago in a farm attack. The bullets severed his nerves in the pelvic area. He lost control of his right foot and wears a brace on it to keep it steady and to help with walking. The blood circulation is also compromised in his leg, which leaves his leg constantly cold – he lives in constant pain.
We heard that there's a doctor in Nelspruit area that works with people with Nerve Damage that can possibly help in repairing the nerves in his back. Is there any chance that you could help in finding this doctor or someone else that could help my dad? My parents do not have a medical aid.
A: I am not aware of anyone specific but if there is, it would be a neurologist or neurosurgeon. If they don't have a medical aid, I would suggest you ask for a referral to the Neurology department at Steve Biko or Charlotte Maxeke academic hospitals to see a specialist. An operation may be very costly.
Q: Shingles pain relief
I developed severe trijeminal shingles about 2 weeks ago. I still have sores on my face and my eye is still very swollen but the pain is so excruciating.
I was taking Tramal and Lyrica for the pain, but they were not working so well and they just seem to knock me out. At present I am alternating between Myprodols and Synap Forte. Is there anything else that I can take for pain that will last longer? The pain is so bad that I am only able to sleep 4 hours a night. Any advice would be welcome.
A: This is a very painful condition. Other medications they can try are Tryptanol or Gabapentin if the Lyrica does not help. It is a nerve pain so normal pain medication is not very effective. On the healed areas you can try Sloan's liniment.
See also http://www.mayoclinic.com/health/postherpetic-neuralgia/DS00277/DSECTION=treatments%2Dand%2Ddrugs
Q: Painful breasts
For the last month and a half I have been experiencing breast pain on my left breast. It aches and throbs all the time and when I touch it, it hurts and sometimes my nipple feels like it's burning. I know I should go to the doctor however I am terrified of the results. The shape and size is exactly the same as my right breast, however it is constantly paining.
I am really scared doc, I am only 23 years old and I don't know what the cause of this might be. Would a normal GP be able to examine and tell me?
People say it can be anything, but in my mind all I think of is breast cancer. Please advise.
A: Yes, your GP will be able to examine you and he/she will send you for a sonar if needed. You may have a cyst or a harmless fibroadenoma. You may also just have mastalgia - breast pain due to hormonal cyclic changes.
For several months now I have been itching all over my body. Most especially my head, face,eyes and nose. It doesn't stop there, that is just the most severely affected. There doesn't seem to be any external problem (in other words: no rash, discolouration or lacerations). The itching does not stop at all. I find that I take longer to fall asleep as I have to scratch constantly. I'm a 36-year-old woman weighing about 50kg with no serious health problems. I do, however, suffer from chronic migraines, heavy menstrual flow and frequent low blood pressure. Lately, I have, however, been suffering from a decreased appetite, nausea and stomach cramps. What could be the cause?
A: Liver problems can cause an irritating itching in the skin. Please ask your doctor to check your liver functions and kidney functions with a blood test (and while you are there, check your iron levels and full blood count too to exclude anemia)Let him have a look at your tummy, you may have gastritis (stomach lining inflammation) or a peptic ulcer.
Q: Flu symptoms
I have high temp, vomiting, and flu-like symptoms. I can't eat much, and I'm coughing a lot. What kind of flu is this?
A: "Normal" seasonal flu and swine flu have the same symptoms, and the kind of flu can just be determined by blood tests. If you have high fever, can't keep fluids in or feel short of breath you should rather see your doctor
Q: Bleeding haemorroids
My grandmother is an IBS (Irritable Bowel Syndrome) sufferer and is always constipated. She is also on Warfarin, and she began bleeding form her anus since yesterday. We suspect it might be piles. It's not just when she goes to the bathroom, but every time she stands up. We are really concerned, should we take her to the doctor or first try a home remedy?
A: No, please take her to the doctor, she may become very anaemic if this is not treated quickly even if it is just a bleeding pile.
Q: Excessive night sweats
My son is 21 and he complains of excessive night sweats. Is this something that I should concern myself about?
A: Yes - let your GP examine him and draw blood if needed to look for underlying infections, diabetes or thyroid problems.
Q: Subject: eye twitching for almost 2 weeks
My eye has been twitching so much lately on the left side in such a way that I am now concerned and I feel like my left eye is becoming retarded. This movement often happens once in about 3 hrs and it continues to twitch for about 30 minutes at a time.
I'm considering going to the optometrist, but I am not sure what do I say to him when I get there. People say it'll go away over time but its almost 3 weeks now! Please help.
A: Try taking a muscle relaxant like Norflex and putting a warm face cloth on your eye. Or try using antihistamine eye drops like Spersallerg. The most common causes are eye strain, stress, too much caffeine or lack of sleep. If it does not improve, you may need to see your GP to check for other causes, or to see if botox injection into the muscle is needed.
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(Joanne Hart, Health24, August 2010)