DEAR DOC: Why the frequent infections yet I am not sexually active?

Dear Flo, I am frustrated and depressed. I keep getting these recurrent and nasty infections and vaginal discharge. I have been treated by all the doctors,  literally, and taken more medicine than I can count. I know it’s not sexually transmitted because I am not active. Where can I seek help? Thanks, Judy.

Dear Judy,

Our bodies have many bacteria and fungi that live in them. All these organisms need to exist in a delicate balance because if one reduces, another one multiplies to take its place, and that always causes a problem. The vagina also has its own natural organisms, and one of them, called lactobacili, helps protect the vagina from infection by producing acid. If the lactobacilli in the vagina reduces for any reason, then the other bacteria or the fungi, like yeast/candida, multiply and cause a discharge.

This is not an infection from someone else; it is from the organisms that live within or just outside of the vagina. This is different from getting a sexually transmitted disease. This imbalance of the vaginal organisms can be triggered by using antibiotics, hormonal changes like those that happen every month during the menstrual cycle, or those that happen during pregnancy, use of steroids or hormonal medication, diabetes or any other illness that affects the immune system.

What this means is that you can get recurrent vaginal discharge without an external source, and it can be due to your monthly menstrual cycle or any of the other reasons. There is no way to assure you that you will never get it again, but it can be treated every time you get it.

You need to visit and follow up with one gynecologist for vagina swab examination and culture, and a pelvic scan.

Once the diagnosis is established, you will be put on medication, and given advice on what to do in future. You might need to be put on medication for several days every month for some time to try and control the infection. Be encouraged, even though there is no permanent solution, the problem can be managed.

Dr Flo, what causes swelling of the feet? Is there a lasting solution? Why do some swell while others don’t? Any medication used to eradicate the problem? Momanyi

Dear Momanyi,

 The swelling of the feet occurs due to accumulation of fluid in the tissues. This can happen when there’s too much fluid (plasma) in the blood, or there is blockage of the drainage of fluid, or there is increased pressure within the blood vessels or increased leakage of fluid from the blood vessels (capillaries); or there is a decrease of some components in blood like sodium and proteins.

The causes of this may be reduced movement/activity, varicose veins, obesity, heart failure, kidney failure, liver failure, some lung diseases, malnutrition, blood clots, pregnancy, hormonal problems and use of some medications.

Some people, especially women aged between 20 and 40 years, may have swelling of the feet for no obvious reason.

The swelling itself is usually not the cause of concern; what is more important is to find out the specific cause of the swelling and deal with it.

If it is due to reduced movement or lack of physical activity, then the solution is to increase activity. If the cause is kidney failure, then the kidneys need to be dealt with. Some issues are for a short time such as pregnancy, while some cannot be completely gotten rid of.

There are medications (diuretics) that can help to reduce the swelling, but they are a short term solution since they do not deal with the underlying problem. There are also temporary measures of dealing with the problem like using compression stockings, elevating the feet when resting and at night and massaging the legs in the direction of the heart.

I hope this answers your questions.

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