DR FLO: Why is my husband’s cold taking too long to go away?

Dr Flo, my husband has been suffering from a cold since last August. It has smelly discharge and sometimes causes headache and fever. He has been to hospital and treated for allergies, but once the medication is over, the symptoms return. What can we do to cure this once and for all? Anne

Dear Anne,

It is likely that your husband has allergic rhinitis, which means that his immune system reacts strongly to dust, strong smells, pollen, smoke or cold and this leads to a runny or stuffy nose that causes headache.

Allergic rhinitis can be passed from parents to their children and it cannot be completely cured. It is associated with other allergy conditions like allergic skin rashes, allergic cough, recurrent itching of the eyes (allergic conjunctivitis) and asthma. It can be controlled by avoiding the triggers and by taking anti-allergy medicines.

Your husband may also be suffering from sinusitis. Sinuses are air pockets in the skull which open into the nose. In sinusitis, the lining of the sinuses is inflamed and the sinuses fill up with mucus. Bacteria can grow in the mucus causing infection. This can be triggered by the common cold or by allergic rhinitis or by a growth inside the nose (nasal polyp) or by any abnormalities in the structure of the nose. Someone who has sinusitis may have a runny nose or a feeling of nasal congestion, loss of the sense of smell, feeling of mucus running down the throat (post-nasal drip), throat irritation and/or cough, bad breath and headaches. When there is an infection, the mucus is usually yellow or green, thick and foul-smelling, and there is fever and severe headache or facial pain.

It would be advisable for him to be on follow up by an ear, nose and throat (ENT) specialist. Allergy symptoms are treated with anti-histamine medication and sometimes steroid tablets or nasal sprays. Sinus infection is treated with antibiotics. Depending on severity and duration of sinusitis, surgery may also be done to drain the sinuses.

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Dr Flo, I got a kidney transplant. Since then my right testicle has been swollen, although it is not painful. What is the cause and remedy? ZM

Dear ZM,

It is common for male kidney transplant recipients and donors to experience testicular pain and/or swelling on the side that the procedure was done. Sometimes there is injury to some blood vessels or the nerves or damage to the drainage mechanism (the lymphatic drainage), all of which can contribute to the swelling. There may be accumulation of fluid, blood or pus around the transplanted kidney which finds a way to drain to the scrotum. This may occur due to the body rejecting the new kidney.

Away from the kidney transplant, it is also possible to develop testicular swelling due to hydrocele, infection, torsion (twisting and swelling of the testicle), tumour, scrotal oedema (swelling of the sac that contains the testicles), infarction (poor or absent blood supply causing pain and swelling), rupture or accumulation of blood due to trauma.

Inform your transplant team about this so that you can get a proper evaluation and corrective measures can be instituted. You will require a scrotal ultrasound and an abdominopelvic ultrasound to look at the testicles and the transplanted kidney, among other tests.

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Dr Flo, my urine has a foul smell that was not there before. It also seems more concentrated than usual. I have tried to drink a lot of water but there has been no change. Please help. Jo

Dear Jo,

The most common cause of change in smell and colour of urine is a urinary tract infection (UTI). Urinary tract infections are common in women, and in about 20 per cent of women, the UTIs are recurrent.

The bacteria that cause UTIs live in the intestines and travel from the anus to the urethral opening (where urine comes out). Women also have a short urethra (the tube that carries urine to the outside) which makes it easier for bacteria to travel up to the bladder and cause infection. The bacteria can also get to the urethra when using a dirty toilet due to splashing, and due to close contact during sexual intercourse.

Having a UTI may cause a burning or irritating sensation when passing urine, feeling very pressed, urine leaking out before you get to the toilet, urinating many times, even though very little urine comes out; change in urine colour and/or smell, blood in urine, lower abdominal pain, lower back pain, fever and chills, nausea, bloating and feeling tired. UTIs are treated with antibiotics after a urine test. Make sure you complete the antibiotics course, and take a lot of water.

Other causes of foul smelling urine and change in colour include dehydration, hormonal changes during ovulation or pregnancy, some medications (like vitamin supplements, TB medication), some foods (asparagus, garlic, curry, onions, Brussel sprouts, alcohol, and caffeine), and some serious medical conditions like diabetes, kidney disease or metabolic disorders.

To prevent UTIs, go to the toilet as soon as you need to and empty the bladder completely; always use a clean toilet; take a lot of water every day; wear cotton underwear and loose-fitting trousers; avoid scented soaps, feminine hygiene products and douches; wipe yourself from front to back and clean the genital area before sexual intercourse and urinate immediately after sex.