The Doc Replies

Worried sick about falling ill on holiday

Q My husband and I are going on holiday to the Dominican Republic this year. We’re staying in a good resort but are worried about getting ill. Do we need any jabs? 
A

There are vaccinations recommended for this country but some, such as measles, tetanus and rabies, you may have had already. Malaria tablets are also advised for most areas including the resorts. Your practice nurse may run a travel clinic to advise on immunisations and check which you’ve already had. If your surgery doesn’t offer this ask them where you can find your nearest specialist travel clinic or see your doc at least four to eight weeks before travelling. You should also take insect repellent with you.
Q What are the symptoms of and treatment for hyperparathyroidism and is an op necessary? 
A Symptoms of an overactive parathyroid gland often involve changes in calcium levels so there may be kidney stones, problems with bones and calcification of parts of the body such as the cornea, a feeling of being generally unwell and excessive thirst. You can get primary, secondary and tertiary hyperparathyroidism and treatment depends on the type and severity. In extreme cases the gland may be removed. 
Q What do small black splinters under my nails mean? I have them for a while and then they disappear. 
A

These are sometimes called splinter haemorrhages and are caused by a variety of problems. It’s possible you’ve had some trauma to the area or it might be due to an infective condition such as infective carditis. They can be due to a rheumatoid condition, fungal or yeast infections or blood disorders.  

Q just been diagnosed with diverticulitis — any diet or lifestyle changes I should make?
A Most people don’t have constant problems but intermittently you may get flare-ups when symptoms can be severe. During an attack you should have a low-fibre diet until the problems have passed but for the rest of the time you need a high-fibre diet with lots of liquid, take plenty exercise and avoid anti-inflammatories such as ibuprofen.  
Q I have pins and needles and tightness in my head. It feels like there’s a weight on my head and it’s making me dizzy.
A

These symptoms could be caused by tension or stress or a non-specific viral illness. See your doc for an examination.
Q Are evening primrose capsules good for anything other than PMS? I’ve read it helps with recovery after an op. Does it help with psoriasis? Is cod liver oil or primrose oil best for arthritis?
A Evening primrose is mostly used for PMS and I haven’t heard of it being used after surgery. It’s also used for eczema, psoriasis and rheumatoid arthritis. It may help with high cholesterol and heart disease. Hard to say which is best for arthritis but I know some patients who take both. 

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