WHY DO SIGHT PROBLEMS INCREASE WITH AGE?

Doctor,

I have been a smoker for about 10 years now. I would like to quit and immediately start working out but even taking a flight of stairs leaves me feeling like I have no air left in my lungs. I know it is going to be harder for me as a former smoker to jog or do any other sport but I am determined to begin as soon as possible. What can I do to reduce on the discomfort in my chest? Is it dangerous to immediately go into working out or do I need to wait for sometime at least?

Karemera

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Dear Karemera,

You have taken a good decision to quit smoking, even after a decade. Cigarette smoke contains more than thousand harmful chemicals. This along with the tar and smoke cause chronic irreversible damage to the inner lining of entire respiratory tract beginning from nose, wind pipe, down to lung parenchyma.

This affects the ventillatory capacity of the lungs, making one feel out of breath after walking a short distance. Climbing upstairs or uphill, puts greater strain on body than walking on plain ground, hence more oxygen is needed. The body fails to get it due to impaired functioning of the lungs. Therefore one becomes breathless on climbing stairs. This condition can progress, if not checked.

Nicotine, the addicting substance present in tobacco, causes narrowing of blood vessels of the whole body, resulting in hypertension. Chronic high blood pressure, strains the heart, resulting in heart failure. In early stages, this manifests as shortness of breath on exertion. Tobacco is also an independent risk factor for coronary artery disease, where blood vessels supplying blood to the heart are blocked in various degrees. This can cause chest pain and breathlessness on exertion.

You should get tests done to find out the underlying cause or causes of breathlessness and chest discomfort. All the possible conditions are treatable. This would include check up of blood pressure, BMI, blood sugar, blood lipids, X-ray chest, lung function tests, electrocardiogram and cardiac echo. If coronary artery disease is suspected, coronary angiography can show the blocks in coronary arteries. That can be removed by interventions like putting stents in coronaries or bypass surgery.

You can begin work outs as soon as possible, but after knowing overall health status. The work out should be as per the overall medical condition of the body. Any exercise initiated should be increased progressively, as per the stamina. The exercise should be stopped immediately if one feels breathless or some discomfort in chest any time. Yoga, brisk walking, light jogging, swimming, aerobic exercises are the exercise of choice for you. You can do one or more of these exercises. In fact, "pranayam”, or breathing exercises of yoga are very beneficial in such situations. They are also useful in helping quitting smoking and overcoming the withdrawal symptoms. Weight lifting and muscle building exercises should be avoided as they tend to increase more adrenaline in the body, thus increasing high blood pressure.

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I AM ADDICTED TO RAW SALT

Doctor,

I don’t like putting salt in my food while preparing it, but I prefer adding it directly after the meal is ready. Does raw salt have effect on someone’s health?

Lydia

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Dear Lydia,

Raw salt has many uses in the body. It helps to maintain fluid and electrolyte balance of the body, helps to maintain the body temperature, aids in various physiological processes of the body and adds taste to food. But the natural salts like rock salt or sea salt prepared by drying sea water, are better than the processed table salt used for modern day cooking.

The processed table salt, i.e. sodium chloride is processed and made of chemicals which are harmful. The whiteness of this salt is because of bleach, which is harmful for human health.

Excess of salt is harmful for the body. It tends to put a load on the kidneys in eliminating it, eventually leading to kidney failure. The salt content causes retention of salt and water, putting a load on blood vessels and heart.

This becomes a cause for high blood pressure and heart problems. Processed salt lacks naturally occurring iodine and regular use can lead to hypothyroidism, manifesting as swelling over body, early fatigue, dryness of skin and altered bowel habits. This salt gets cooked at really very high temperatures more than 100 degree Celsius. Hence there is no guarantee of it being cooked along with food, which is a common myth.

As such all naturally occurring substances like vegetables and fruits, have salt inherently present in them. Hence one can use them, without adding any salt. It is advisable to take up to 2gm of salt per day if there is no chronic problem and less than 1.5gm if you have hypertension or heart problems.

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I HAVE FAILED TO CONCEIVE

Doctor,

I have been trying to conceive in vain, yet this is my second year in marriage. Is there anything to worry about as I have done all the tests, yet they all confirmed I was fine?

Alice

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Dear Alice,

You have not mentioned your age. Did you use any contraception before? There are multiple reasons for not conceiving.

Pregnancy occurs due to proper balance of the hormones estrogen and progesterone. If one has any hormonal imbalance due to disorders of the ovaries, thyroid or pituitary gland, it affects conception. Hormonal contraceptive pills or injections taken for few months continuously can affect fertility. Another common cause for infertility is blockade of the fallopian tubes. This commonly occurs due to pelvic infections or inflammation, secondary to sexually acquired infections. Adhesions can also form in the fallopian tubes due to trauma occurring in previous child birth or due to some intervention. Infertility can be due to abusive substances like alcohol and tobacco.

At times, the fault may lie with the husband. Absence of sperms or inadequate quantity of sperms can occur in a man due to childhood infections like mumps which affects the testes. Inflammation of the testes or blockade of the tubes carrying sperms can occur as sequel to sexually transmitted diseases and makes a man sterile. Putting a laptop computer over the thighs for long hours continuously, tends to raise scrotal temperature, impairing sperm production. Use of very tight underwear or nylon underwear by men has similar effect of reducing sperm production.

A couple may not have any problem physically, but they fail to conceive a baby due to wrong timing of coitus. Pregnancy occurs when intercourse is done during the fertile period of a woman, i.e. at time of ovulation. Ovulation occurs somewhere between 14th-21st day of menstrual cycle (counted from 1st day when menstrual bleeding occurs).

This can be assessed by recording basal body temperature or examining cervical mucous (discharge from lower end of uterus), which becomes thick and tenacious during ovulation. Serial ultrasound examination of the pelvis helps to pinpoint the time of ovulation, which can be utilized for intercourse or external interventions. Sometimes the pH of the vagina is too acidic preventing sperms to enter and fertilize the released ovum. This can be corrected by using alkaline douches.

If you are young, i.e. not more than about 35 years or more, there is nothing to worry. In fact mental stress is also known to cause infertility by causing spasm, hence block of tubes in both partners. Remain relaxed and stress free, plan coitus around ovulation, with aid of ultrasound examination. The partner should also be investigated to detect any problem he may be having. With advancing age, chances of fertility reduce because of reduction in number of eggs released, reducing estrogen levels and many other chronic diseases as well. In that case, it is advisable to consult a gynecologist and discuss other options of conceiving like artificial insemination or in vitro fertilization, among others.

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I DON’T LIKE TAKING WATER

Doctor,

I have a problem of taking water, yet my doctor advises me to take at least 8 glasses per day. Whenever I do that without having taken a meal or snack I feel like throwing up. What should I do?

Moses

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Dear Moses,

Drinking eight glasses of water every day is very useful. Water constitutes 70 per cent of the body. At times dehydration and dryness set in due to inadequate amount of water.

Drinking an adequate quantity of water, corrects this problem, preventing dehydration. It tends to cleanse the body internally, removing microbes from the urinary system and activates the kidney. Drinking adequate quantity of water also aids in digestion and prevents constipation. It helps in various physiological processes of the body.

Hence one is advised to take minimum 8-10 glasses every day. But if you are not used to it, you may feel nauseous after drinking it. This happens more so if he consumes water in a quantity more than one is habituated to. Taking much water in one time can dilute electrolytes of the body, causing weakness and nausea.

Drinking water after a heavy meal, drinking alcohol with meals or drinking sodas in excess, are other reasons due to which a person tends to throw out after drinking water. If there is some other underlying cause for functional dyspepsia like chronic gastritis or Heliobacter pylori infection, nausea can occur after drinking water. Allergy to some food can also cause nausea, drinking water at that time and feeling nauseaous can be just a coincidence.

It is advisable to drink water in small quantities throughout the day and increase the quantity gradually. Meals are also good if taken in small quantities, 3 or 4 times every day.