Heart TO Heart

Q: My best friend, who is also my colleague, has recently developed a bad problem with sweat and she literally stinks most of the time. Everyone else in the office makes fun of her behind her back and avoids going close to her. I feel bad but she hasn't picked up on any of my hints. Her problem is getting worse and these days I try and avoid going out with her. She recently told me that my behaviour and that of our colleagues was hurting her. I fell bad when she said this. What should I do? Nayema, Lahore
A: As her best friend you should talk frankly to her. Do not be embarrassed. Tell her about her problem because she seems unaware of it. You can then discuss what she can do. Since this is a problem that she has developed recently, check if she has changed her deo or started on some new medication. Once she becomes aware of the problem, she will be able to work out what is wrong. You can help her in this. Being a good friend means standing by the person you call a friend and you haven't been a good friend in this regard. Make sure that you don't make this mistake again.

Q: I am a college boy and my problem is that I am more intelligent and hard-working than my best friend. He copies all my notes and assignments and now he wants me to help him cheat in the final exams. He says that he has a plan that is absolutely safe and that neither of us will get into trouble. But I am scared. What should I do? I do not want to lose this friend or be thought to be a coward. Confused Dost
A: You should tell your friend that you will not help him cheat and then stand firm. Yes, as a young student, you want to keep your friends and be thought to be a sport. But cheating in an exam is not just a matter of helping a friend it is doing something for which you can get into real trouble. You too can be punished for helping in cheating and that will mean a blemish on your record. You should not be afraid of losing your friend, because if he is a real friend, he will understand your point of view. And by refusing to someone cheat, you are not being a coward; you are doing what is right. After all, cheating is wrong. So stand firm.

Q: Since I can remember, I have been terrified of many things the dark, strangers, water, new places, etc. In fact I was so terrified that I had to stop my education and stay at home.
Now, I am 32 years old and things are so bad that I never leave the house. My parents have taken me to doctors but they say that nothing is wrong with me. Now, everyone in the family is desperate. Am I mad? Ghousia, Karachi
A: "Mad" is a word which we often use, but it has no exact scientific meaning. Mental problems are of many kinds and yes, you have a problem. But to call yourself mad is meaningless.
You need to see a psychiatrist. Probably, an incident that occurred in the past, perhaps when you were a child, upset and frightened you so much that you still haven't recovered from it. A psychiatrist will take you back into your past and once you face that incident you will understand why you are still afraid now. The psychiatrist will then help you get over the fear.
The process will not be easy and may take time. But if you really try, you will be able to get over your phobias and lead a normal life.
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Dermatologist
Dr Shah Hussain

Q: My 13-year-old son who suffers from cystic fibrosis and is very embarrassed at the dryness and shrivelling of his hands when swimming. It is very bad, not just the usual dryness when hands are immersed in water for a while, they really shrivel up. He doesn't want to swim anymore and as swimming is very good for him, I am worried about this problem. I have tried lots of creams, but nothing seems to work. Can you help? Bushra, Karachi
A: I agree with you that swimming is a good form of exercise for your son because of his history of cystic fibrosis. You say that you have used various creams without much success. I would suggest that you get some emulsifying ointment. Your son should apply this to his hands before he departs for the swimming pool. This will help to moisturise his skin but do forewarn him that his skin may feel slightly greasy. Your chemist could also advise you about a suitable emollient that he could use when showering after his swim. This will also help to moisturise the skin.

Q: I have two large enough moles on each cheek of my face. I think I've got them from exposure to the sun. I haven't gotten them tested yet, but I really would like them removed. Is this possible and safe? Rafia, Lahore
A: It is perfectly safe to have these moles removed. Since they are located on your face it might be best if they were removed by a plastic surgeon in order to ensure that you have the best possible cosmetic result. It is extremely unlikely that they are cancerous but even if they were, removing them would not be dangerous because the whole lesion is usually removed. In other words the whole lesion is removed at the one sitting rather than removing a portion for tissue diagnosis and then going back later to remove the rest. This procedure is referred to as an excision biopsy. The tissue is always sent to the laboratory for analysis to confirm that there are no abnormal cells present.

Q: I have been diagnosed as having phlebitis (vein inflammation) in one leg, but can't have anti-inflammatory drugs because I am asthmatic. How can I obtain relief from this painful condition? Simmy, Lahore
A: There may be specific reasons in your particular case as to why you are unable to take NSAIDs (non steroidal anti-inflammatory drugs) but it would be wrong to say that NSAIDs are contraindicated in all asthmatics. Studies have suggested that up to 20% of people with asthma are sensitive to aspirin and in some of those cases aspirin can induce severe asthma attacks. If hypersensitivity to aspirin exists NSAIDs are probably best avoided because the person might also develop hypersensitivity to the NSAID, which could result in a severe asthma attack. If a person does not have aspirin hypersensitivity then NSAIDs can be used provided the person has not reacted against such drugs previously. There are several topical NSAID gels on the market, which might be a suitable treatment for you because there is very little systemic absorption of such drugs into the blood when applied to the area of inflammation. Sometimes antibiotics may be needed to treat phlebitis especially when infection is present. Support stockings or bandages can also be very helpful in providing support and comfort to the inflamed area. It is generally recommended that the affected limb be elevated to reduce swelling, which in turn should also help to reduce pain.
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General Physician
Dr Sadqa Gul
Q: I have been suffering with my ears for over a year now. I think I might have a hearing problem. This has been happening for some time and is not getting any better; I have now just cleared up another infection and am back to square one. Please advise. Amir, Karachi
A: I think that you should request a second opinion because you seem to be particularly frustrated by your ongoing difficulties with your ears. The only way that this can be arranged under our system of health care is through GP referral. Your question suggests that you may have some recurring irritation of your outer ear, which could be due to eczema. This could contribute to deafness because of the clogging up of the outer ear with debris from the eczema. You also refer to repeated episodes of infection, which could be occurring in either the outer or middle ear. Such infections can cause temporary forms of deafness. Thirdly your hearing loss could be due to defects in the inner ear. Perhaps your occupation exposes you to high levels of noise, which can adversely affect your perception of high tone frequencies. I don't think that testing your hearing would itself be a sufficient assessment of your ear problems. Your ongoing ear problems and hearing loss need to be comprehensively addressed and I would recommend that you discuss this with your GP and arrange to be seen by a doctor specialising in ear, nose and throat problems. Measurement of hearing loss would be an important element in that assessment but on its own it would be an inadequate response to your ongoing difficulty.