Medical Hotline with Dr James Wright

drink more
If you work outside over summer, you will need to keep up your fluid intake. An intake of approximately 1.5 to 2 litres of water a day is normal. However, with a large fluid loss, you will need more. The body’s inbuilt thirst factor usually tells you when this is and when you have had sufficient. It is also possible to overhydrate, which has its own side effect.

normal or not?
Where does normal (mis)behaviour end and ADHD start? Overactivity in children is common, and in most is simply an extension of exuberant and energetic activity, and maturity will usually resolve the situation without resorting to intervention. But many children are incorrectly labelled ADHD and placed on unnecessary medication. On the other hand, it is helpful for some, with medication and behavioural therapy producing a positive result. Interestingly, it is often these overactive children who develop into extremely bright, intelligent teenagers, who, because life was not challenging them, compensated with hyper physical activity.

hair removal
Some people unconsciously and habitually twist their hair around a finger, pulling it out without realising. Under constant tension, hair will lift from its follicle. Eventually they develop a bald patch. This is a common cause of hair thinning in teenagers. New hair grows back at about one centimetre per month.

baby care
Many infants and children develop coughs that will continue unabated for months. Most coughs during infancy eventually cure themselves and don’t need treatment. However, a persisting cough may be an early indication of asthma, present in about 20 per cent of children.

decision time
Young women who smoke then start to take the pill increase their risk of blood clot at relatively young ages. One should not do both, which calls for a decision. I suggest stopping smoking as the remedy with the greatest personal benefit. If you stop taking the pill and become pregnant, giving up smoking is absolutely essential to prevent harm to the developing infant.

anti-dextrous
People who are left-handed suffer inequality, as everything is geared to the right-handed. But in the absence of legislation, a simpler option is to become right-handed—at least in some things. It will take time and commitment. (My left-handed brother lost an arm in an accident and, forced into it, soon became right-handed.)

heads you win!
Dandruff is not a horrible disease, although teens might argue to the contrary. It is simply a dry scalp, where the upper skin cells come away in larger flakes. Regular cleansing with a dandruff shampoo, including a moisturiser (often tar- or urea-based), will eliminate it. Also, massage the scalp with the fingertips to promote blood circulation, and brush hair with a non-plastic brush nightly.

tooth truth
People in their 20s and 30s have a brilliant smile but never a filling. Universal fluoridation of water, its use in toothpastes and fluoride painting of teeth has helped this. Regular cleaning and a rinse with water after food helps, and, as always, avoiding sticky sweets is essential for a nice white smile.

warning bell
Bowen’s disease is skin cancer ready to break out and turn serious! The complete removal is best. On the face, it heals quickly, as the blood supply is plentiful. Note, that if you have one, others are likely to develop, so a twice-per-year check is essential.

epidermal dilemma

Q: I was referred to a skin specialist for mole removal. Each time I see him, he removes one more and tells me to come back. Costwise, this is expensive, so is it necessary?

A: Older people have a higher risk of developing sunspots (hyperkeratoses) and skin cancers. It reflects the hours they spent in the sun in childhood. The truth is, you will need to continue for the rest of your life. This condition affects up to 95 per cent of the population. Although SPF sun lotions and sun protection help, past damage is irreversible. Skin cancer can kill, if untreated.

Extract from Signs of the Times, December 2005.

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