Doc, how can I overcome claustrophobia?


So bad is the phobia that I avoid crowded places

Tuesday January 14 2020

Dr Flo,
I suffer from claustrophobia, so I avoid overcrowded places. What can this be attributed to? How can I overcome this?

Dear Alnashir,

Claustrophobia is an anxiety disorder where there is an intense fear of being in crowded or tight places. When you have a trigger such as being in a closed room, or a crowded place (like an elevator), then you experience symptoms like for a panic attack. This include feeling intense fear, sweating, hot flashes, trembling, feeling confused or lightheaded, nausea, chest tightness, fast heartbeat and shortness of breath or hyperventilating. These symptoms usually subside after some time. Claustrophobia develops in childhood or teenage years in most people. It may have been caused by an incident of being stuck in a closed or crowded space either for a long time or against your will (for instance, being punished by being locked up in a closet) or in a life-threatening situation (such as severe turbulence while in an aircraft. Genetics and brain changes can also contribute to claustrophobia.
Claustrophobia is best managed by a mental health professional using psychotherapy including cognitive behaviour therapy, visualisation and relaxation and/or exposure therapy. Medication may also be prescribed to deal with the panic symptoms.

Dr Flo,
What is a stroke? Is it clotting in the brain that triggers this? Does it lead to paralysis? Also, what is an aneurysm?

Dear Walji,

A stroke occurs when a part of the brain dies because it does not receive blood and oxygen. This happens because the blood vessel is blocked by a clot (ischemic stroke) or it has burst/ruptured (haemorrhagic stroke). A transient ischemic attack (TIA) is a mini-stroke caused by a temporary blockage by a clot. The symptoms that one gets depend on which part of the brain has been affected. For example, if the part of the brain that controls speech is affected, then there will be a problem with speech. If the part of the brain affected controls muscles in an area of the body, then there will be paralysis of that area of the body. An aneurysm is a section of a blood vessel where the walls have become thinner, weaker and stretched out, which makes it easier for that part of the blood vessel to burst. You may be born with an aneurysm or develop one later on in life. The risk factors for developing an aneurysm include high blood pressure, smoking, obesity, lack of physical activity and poor diet. Most aneurysms do not cause any problems, but in a few people, they may cause pain, blood clots and internal bleeding, which can lead to death.

Dr Flo,

My daughter, almost seven years old, has had recurring tonsillitis since her childhood and has been getting antibiotics. What is the problem and the cure?


Dear Sanyu’z,

The tonsils are lymph nodes which are found in the throat on both sides. They are part of the body’s defence mechanism, helping to prevent infections. The tonsils can themselves become infected by bacteria, viruses or other organisms, and this is called tonsillitis. It is a common infection in childhood due to exposure to germs and also because the infection can be easily transmitted through cough, sneezing and touching contaminated surfaces.
If there is tonsillitis five to seven times in one year, or at least five times in each of the previous two years, or at least three times in each of the previous three years, then it is recurrent tonsillitis. This can happen because there is a biofilm of resistant bacteria on the surface of the tonsils or because genetics make the body’s immune system have a weaker response to the bacteria causing tonsillitis. The only permanent solution to this is removal of the tonsils. This should be done after consultation with an ENT (Ear, Nose, Throat) specialist. To prevent infections, avoid anyone who has tonsillitis or a throat infection, maintain good hygiene (washing hands regularly and cleaning surfaces) and take the appropriate medication when unwell to prevent spreading the infection.

Dr Flo,

I have a painless lump on my thigh. A doctor told me it has some fat tissue, but it’s not dangerous. What brings this? Will it go away if I lose weight? How can I get rid of it?


Dear Wanjala,

This is a lipoma, which is a growth of fat cells located just below the skin. It may be found anywhere in the body, but is most common on the arms, thighs, neck and armpits. The lump usually grows slowly, and is painless. It does not normally grow beyond 5cm, though some people have quite large lumps. It usually moves under the skin, and it feels soft and rubbery, and may feel like it is slipping from your fingers. There is no known cause for developing lipomas. In some people, it may grow at the site of a minor injury. It also seems to run in families. That is, if you have one, there is likelihood that you also have a family member who has one. The growth of a lipoma has nothing to do with your weight or cholesterol levels, and losing weight will not decrease it. It is diagnosed by examining it, but for confirmation, the doctor may ask for an ultrasound scan and an aspirate test for the cells within the lump to be examined.
It’s not cancerous and usually does not require treatment. It can be removed if it becomes painful, infected, if it is growing very fast, or if you request for it to be removed. The only way to remove it is through a surgical procedure, which is a minor procedure if the lump is just below the skin.
There is no way to make sure you never get another lipoma, though most people who get them usually get only one lipoma in their lifetime.

Send your medical questions to [email protected] for free expert advice