DR FLO: Doctor, why does my hand hurt when I write?

Dr Flo, I struggle with writing. I cannot hold a pen and write coherently without supporting it with my other hand. I am so slow in writing that I have had to put my studies on hold. I also feel pain in my elbow when I write and I can't move my arm with the writing motion. What’s the issue? Kelvin

Dear Kelvin,
Writing is a complex activity that involves several regions of the brain, and the message is passed through nerves in the spinal cord and down the upper limb, and executed by the muscles in the fingers.

When there is a problem with writing, it could originate from one or several parts of the brain, the spinal cord, or the upper limb.
The elbow pain may be caused by a problem in any of the tissues at or around the joint including the bones, the cartilage, the tendons, or the ligaments.

The nerves passing near the elbow can also be trapped if there is cubital tunnel syndrome or radial tunnel syndrome.
You need to see an orthopaedic specialist and a neurologist so that the specific cause of the problem can be identified.
In the meantime, cold or hot packs, pain medications and a simple splint, like an arm sling, can help with the elbow pain.

Dr Flo,

I am a 21-year-old man. I was diagnosed with Myasthenia gravis seven months ago. I am on medication at the moment but I still experience some side effects.

I think it also affects my moods, especially in the morning and late in the evening.

I usually don't feel like talking to anyone. What can I do about it? I need some improvements. CK

Dear CK,
With Myasthenia gravis, the body produces antibodies that fight against the body, interfering with how nerves communicate with muscles.
This results in weakness and easy fatigue of the muscles that you normally control.

It cannot be cured completely because the body is fighting against itself, but there are medications to control it.

These include corticosteroids and immune-suppressants which reduce the activity of the immune system, and cholinesterase inhibitors which improve communication between the nerves and the muscles.

These medications are quite strong and have several side effects.

Very high doses of steroids can cause mood changes in some people. However, having a chronic illness or suffering the medication side effects can also cause low mood.

Low mood can also be caused by major life events or alcohol use.

It is advisable to discuss the side effects you are experiencing with your primary doctor, including the low mood, so that together you can weigh the benefits and the negatives and choose medication that will work best for you.

It may also be beneficial to see a psychologist for supportive therapy.

Dr Flo, I have recently noticed a bad odour in my vagina and I don't know if it could be linked to having sex a lot.

The odour appears when my monthly periods are about to start. Could it be a major problem?

Please help. Annita

Dear Annita,
The vagina has a normal musty smell, which changes due to hormonal changes at different times of the monthly cycle, or due to pregnancy, menopause, or use of hormonal medications.

The odour may also be different after intercourse due to mixing with semen and/or a lubricant. Some women experience a metallic smell during their periods due to the iron in the blood.

A change in the odour can also happen due to sweating a lot, or due to taking foods or drinks that have strong smells like garlic, onions, caffeine and some fruits.

These changes do not require treatment.

If, in addition to the odour you have itching, or an abnormal discharge, or low abdominal pain, then most likely you have an infection, and it would be advisable to see a doctor so that you can have tests done to get an accurate diagnosis and be put on appropriate treatment.

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