Dr Flo, I cannot walk nor work under the sun, because it makes my skin prickly and I end up scratching myself vigorously. I also get pimples which disappear after my body cools. I have taken antibiotics, used medical soaps and taken cetrizen and levo-cetrizen to no avail. Kindly help. Wahome
You have cholinergic urticaria or heat hives. When your body temperature rises, your body releases some chemicals called histamines, and others.
These chemicals cause itching, redness, a prickly feeling, pimples, and sometimes shortness of breath and/or wheezing. In some people, these reactions occur on exposure to sweat. It may also happen after eating spicy foods or when you are excited or angry.
It is more common in people who have allergies, and also in people who sweat less than others (hypohidrosis). The condition is more common in men, and tends to start in teenage or in the early twenties. It may come on and off, or last for several years before stopping for a period.
Unfortunately, it has no known cure. To manage it, do your best to avoid any known triggers. Other treatments that may help include use of anti-histamines, steroids (in severe cases under doctor’s instruction), UVB therapy and sweat/exercise therapy. Do not overdress, and use ice packs to quickly cool yourself. Avoid aspirin, alcohol, and other drugs, because they can trigger the symptoms.
Dr Flo, I am 38. I work the day shift (5.45am to 6.15pm) for four days, then I take a day off; then I work the night shift (5.45pm to 6.15am) for four days, followed by three days off-duty. My energy levels during the night shift diminish exponentially in the wee hours of the morning. I eat relatively healthy meals, hydrate often, and do moderate exercise – jogging 10 kilometres a week – whenever I can. My indulgences are coffee and the occasional tipple when I am off-duty. What steps can I take to ensure that I stay alert during the night shift, as is required of me? Edwin
You seem to be in excellent physical shape and you take good care of your body, both with diet and exercise. However, this cannot ascertain high energy levels through the night shift.
To be in the best shape, in addition to proper diet and exercise, you also need a regular sleep routine, which unfortunately is not possible with shift work.
You are supposed to go to sleep at the same time every day and wake up at the same time every morning. The body has an internal clock, the pineal gland, which keeps time for us, so that even if you had slept through the day, the body still recognises that when it is night, you should be asleep. This is what gets “confused” when you cross time zones, leading to jet lag.
An irregular sleep routine can lead to chronic fatigue, sleepiness while at work, reduced performance and problems with inter-personal relationships. There is also an increased risk of accidents, heart disease, gastrointestinal illnesses, irritability and depression.
For some people, taking short naps during the night shift helps to replenish energy for the wee hours of the morning. Do your tasks with other people and do the most boring tasks at the beginning of the night. Be active during your breaks e.g. take a walk or do a physical activity. Make sure to rest well during the day and avoid alcohol and caffeinated drinks when you are supposed to be sleeping during the day.
Dr Flo, I am 32 years old. I am married to a 30-year-old woman. She is not on any contraceptive but she says that she can’t get pregnant and that she will never have a child of her own. She used to drink a lot before we got into a relationship, but I have managed to keep her from drinking most of the time, though during functions and brunches she drinks until she passes out. Sometimes when she is really drunk, she asks for a cigarette. I wonder if this (the drinking and smoking) is why she can’t conceive. Strange enough she can spend a whole day or even a weekend sleeping. We argue a lot because she rarely takes a bath or does the house chores; she is just interested in her social life. I asked her if we could start exercising to make our bodies active, since she sits the whole day, then spends the rest of the time in the house sleeping or watching TV or going out, but she refused. I don’t want to tell her that she is lazy. Please help me understand her condition. Mbugua
Since your wife says she cannot conceive, find out from her if there is an underlying issue that she knows about.
If you have been trying to conceive for over a year, you need to visit a gynaecologist so that tests can be done to figure out what the problem may be, with either of you. In the meantime, your wife should cut down on alcohol consumption and stop smoking because they are some of the factors that increase the risk of infertility.
Regarding the issue of reduced activity at home and sleeping a lot, she may need to be evaluated for an illness like depression, anxiety or hypothyroidism (thyroid gland that is not as active as it should be). There may be an underlying illness causing this behaviour, or there may be a problem in the relationship.
You also need to discuss your expectations of each other and the realities of your situation. If need be, please see a counsellor to help you discuss these issues.
In last week’s Healthy Nation a mother asked if it was normal for her six-year-old daughter to be developing breasts.
I would like to highlight a few issues concerning this case:
1.Breasts developing at six years is not normal
2.The child should be evaluated by a paediatric endocrinologist
3.Certain tests should be done to rule out the possibility that the hormones are being secreted by the brain
4.If that is the case, there is treatment to reverse the condition
Dr Anjum Omar, paediatric endocrinologist, Kenyatta National Hospital
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