Multiple neurofibromatosis is a hereditary condition

Q: My father had diabetes, high blood pressure and high cholesterol. He was given medication by a doctor. Three months later, all three are normal. He now wants to discontinue the medicines and drink only a chavanprash tonic for health and vitality as advertised on television. Please advise.

A: Diabetes, hypertension and high cholesterol tend to appear with increasing age. The clock of time cannot be reset. The pancreas will not suddenly spontaneously secrete more insulin. Diet, exercise and medication will keep these diseases under control. If you discontinue the medication, sugar levels, cholesterol and blood pressure will slowly rise. Many patients make the mistake of “doctor shopping”. Asking a second doctor to check your blood pressure or sugar levels without informing him or her that you are already under treatment may lead to a discovery of normal values, resulting in a false sense of security.

Since your father needs allopathic medication, combining it with an ayurvedic tonic, however harmless or beneficial it may said to be, is not a good idea. Also, don’t believe everything shown or advertised on television. Remember it is often referred to as the “idiot box”.

Swellings

Q: I have multiple disfiguring swellings all over my body. They have been diagnosed as neurofibromas. My father and brother have them too. I am married and my wife is pregnant. Will my children inherit this?

A: Multiple neurofibromatosis is a hereditary condition. If it is associated with brown, patchy pigmentation, it is called Von Recklinhausen’s disease. This is the full form of neurofibromatosis. Unfortunately, it is caused by a dominant gene. However, the expression of this defective gene varies so some people only have brown pigmentation while others have a few bumps and lumps. The dangerous growths are the ones that grow in the meninges (covering of the brain) or in the acoustic nerve supplying the ear. Surgery is indicated if there are pressure symptoms, pain or if the tumour is disfiguring. You and your children need to have regular check-ups as the swellings often appear as the person gets older.

Multiple fibroids

Q: I am 38 years old. I have heavy bleeding and pain during my periods. My gynaecologist says I have multiple fibroids and need a hysterectomy. Is this a type of cancer? Can it be treated with medicines?

A: Multiple fibroids are not cancerous tumours. They are due to irregular growth of the uterine muscle under the influence of hormones. They spontaneously regress after menopause. If there are many of them and your uterus has become very large, it may not be possible to remove just the fibroids through surgery. Also, the fibroids tend to spontaneously recur. The average age for menopause is 52 years. You still have many years to go before that, so you and your gynaecologist have to decide on the best course of action.

Hysterectomy is not a complicated surgery. Afterwards though, you must regularly exercise to guard against weight gain and take calcium supplements.

Itchiness

Q: I had jaundice during which I experienced a terrible itchiness. It subsided with medication and disappeared when the jaundice was cured. What had happened?

A: When a pigment called bilirubin is formed in excess, it results in jaundice. Bilirubin makes the skin yellow and can also cause itchiness. As you recover from the jaundice, the levels of the pigment decrease and this reduces the itching. However, medication like antihistamines can be given to control the desire to itch. Scratches on the skin can be prevented by applying non-irritating baby oil or paraffin wax.

Pre-marital sex

Q: I had a couple of boyfriends with whom I had sex. Now I am having an arranged marriage. Do I tell my husband the truth?

A: Arranged marriages are a tricky business. There are no hard and fast rules or norms of behaviour. Your fiancée also is likely to have a few skeletons in his closet. And there is no guarantee that he will “confess all”. Total honesty may seem a good way to start a new life, but it should not lead to a lifetime of accusations, suspicion and recriminations.

Unless you have an STD (sexually transmitted disease) or are HIV positive or are planning to continue to have affairs after marriage, it is best that you don’t say anything. Sometimes, the least-said-soonest-mended principle holds true.

Best option

Q: I am not married and am planning to have sex with my boyfriend. What contraception should I use?

A: A combination of the OCP (oral contraceptive pill) and condoms is probably the best option. The pill will prevent pregnancy and condoms STDs.