Allergies and suitable remedies are one of the issues dealt with this time.
I am a 50-year-old woman, 5'4" and weigh 64 kg. I am in excellent health and exercise more or less regularly. I have lumps all over my arms just under the skin. I noticed the first one some 15 years ago on my right arm just below the elbow. It gave me no pain or discomfort and I ignored it. In the last five years, I have developed such lumps all over my arms, a few on my thighs, one in my groin, some on my stomach and one on my shoulder.
They are of different sizes, most of them about the size of a small lemon, but round in shape. There is one even bigger.
They are under the skin and give me no trouble or pain at all except the cosmetic effect of looking ugly. A few doctors whom I consulted told me they are harmless. Once a doctor even took a cell and got it examined for malignancy, but found none. I find that every time I have an insect bite, the itch turns into a lump and the lump stays although I can't causally link the lumps with only insect bites. The recent spread of these lumps to all parts of the body worries me. Is there a possibility of them turning malignant at any time? Should I have them surgically removed? Is there any medicine, which can dissolve them without surgery? My father who is around 75 also has some lumps on his arms. Please advise.
Dr. Uma Krishnaswamy, General Surgeon, replies:
Multiple lumps under the skin are usually harmless. They may be either derived from fat or nervous tissue and often run in families.
They produce no problems except a cosmetic one. The chance of malignant transformation is very slim. There are no drugs to melt these lumps.
If one of these lumps grows in size or becomes painful, a biopsy may be required. Otherwise, they are best left alone.
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Dilip Kumar Rout:
I am working in a power plant operating on natural gas (produces NOx) in Kakinada, Andhra Pradesh for four years and have started sneezing, which is sometimes not tolerable. I used to have every morning a head bath. I work in shifts every two days) and work for at least eight hours in an a/c control room. I heard it may lead to asthma if unattended. I consulted an ENT specialist who advised me not to take more brinjal, fish, coconut and stop the head bath as precautionary measures. I followed his advice but there has been no improvement. Please suggest a remedy.
Dr. H. Ganapathy, ENT Surgeon, replies:
You have an allergic problem probably due to an environmental cause as you are working in a chemical environment. In the presence of a main offending agent many things can aggravate your allergy including a head bath. Try to get out of the place for a few days or a month and see whether the symptoms improve or not. You have to first eliminate the allergy that already exists from your body by anti-allergic drugs and then go to the new environment. Wait and see. If you are free from symptoms, then your present environment is the cause and not other things. If you do get the same allergic symptoms in the new environment, look for other things like cosmetics, toiletries, food, etc.
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I have allergic rhinitis. When the temperature falls, I experience nose block and sneezing. Itching and dryness is felt and there is severe discomfort during winter. I have found that dust, smoke, pollen and cold weather cause this problem. I can avoid other allergies but not the last. These conditions also trigger "psoriasis". In summer, the nose block vanishes and the skin becomes soft and shining. What precautions can be taken in advance to escape from the attack? What are the safe medicines to control the itching? How can the specific "Ig E" be detected?
Dr. H. Ganapathy replies:
The allergen causing the problem has to be identified and totally avoided to prevent further damage. But it is difficult in cases where multiple factors are involved. Usually, cold weather cannot be the cause of the problem though it can aggravate an existing condition. You have to devise your own method of avoiding cold weather or any offending or aggravating agent. This has to be customised according to the patient's condition. You can discuss the problem with your doctor who can suggest methods to minimise your problems. To control the itching, you have to have antihistamines or steroids. The latter has to be taken under the supervision of a doctor. Otherwise it can lead to complications. Antihistamines are relatively safer but no drug can be taken for a long period without the advice of the doctor. Ig E can be estimated for each allergen. It is laborious and costly.
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After an eye test, a two-year-old child was found to have short sight and power of the glass to be worn is 12. I would like to know from you if there are any precautions to be taken. As age advances will the power of the glasses to be worn increase? Is this case a rare occurrence?
Dr. N.R. Rangaraj, Ophthalmologist, replies:
This is a fairly uncommon refractory error detected in children. The child otherwise seems unaware of a visual world beyond the immediate surroundings. Such children usually develop normal visual function by focussing on small objects held very close to the eye. Congenital myopia is not progressive and is corrected as soon as it has been discovered. Spectacle correction helps the child develop a normal perception of the world around. The spectacle lens should be made of resin or polycarbonate so as to be shatterproof. This helps prevent injuries to the eye in the case of childhood accidents.
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M.S. Ram, Chennai:
I am 75 and am suffering from cervical spondylitis for the past four years. In the early stages, I had giddiness, which was got over by taking Stemetil. Of late, the pain in the neck is acute on the right side. I get some relief on taking Proxyvan or Nise but it is temporary. It I lie down to sleep the neck gets stiff. How long can the painkillers be taken? Do they have side-effects? I am unable to walk straight, but stagger along. I have no sugar or B.P.
Dr. S. Sivamurugan, Orthopaedic Surgeon, replies:
Your principal complaint now is pain in the neck with radiation to the right side, stiffness of the neck and an inability to walk straight. These are symptoms of cervical spondylitis with partial compression of the cervical spinal cord. You will need to see your doctor to ascertain if there is compression of the spinal cord, which is a serious problem. Meanwhile you can continue taking painkillers. But you will need to be careful as too much of painkillers may affect your kidneys. You will get relief by avoiding use of a large pillow and lifting heavy objects. Avoid too many neck movements and head baths every day. Exercises such as shoulder shrugging will definitely help. Avoid neck movement exercises. Stiffness of the neck can be helped by hot water fomentations.
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V.K. Nayar, Vaikom:
I am 83 years old and experience intense pain and shaking all over the body. In particular, there is acute pain emanating from the right shoulder joint due to which the right hand is proving a burden for me because I need support even to lift or stretch it. It is a hindrance to sleep at night as movement is very restricted due to stiffness. Please advise.
Dr. S. Sivamurugan replies:
You have mentioned two problems in your letter. Shaking all over the body may be due to a disorder called Parkinson's Disease. This will require further evaluation and medication. The other problem is acute pain and stiffness in the right shoulder. This may be due to a condition called Periarthritis of the shoulder. In this, there is a stiffening of the soft tissue around the shoulder joint causing pain and stiffness. This can be helped with proper physiotherapy and medication after an orthopaedic evaluation.
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