Health24.com | 7 embarrassing medical questions answered

We’re often told that our doctors have seen everything, and that we shouldn’t feel awkward asking them about things we find embarrassing. 

And on the other side of the spectrum, a problem might seem so insignificant that you’re not sure whether it’s serious enough to warrant a trip to the doctor.

The answers to the following common questions may help. 

1. Sometimes my poop is green. Why?

It’s easy to be alarmed when your stool looks unusual. It’s completely normal for the colour of your stools to be varying shades of brown – and even green at times. Green stools can occur because of the chlorophyll in green, leafy vegetables or supplements. Some colourants and dyes in food may also cause green stools.

Sometimes a yellow-green colour indicates the presence of bile. When you have an upset stomach, bile is not broken down normally and may appear in your stools.

According to our liver expert, dark green stools may also be caused by stress. If this persists, see your doctor.

2. I’m farting more than usual. Should I be worried?

Have you changed your diet recently? Are you eating more fibre or legumes? Did you perhaps overdo it on onion rings or a greasy meal? If so, this could explain your increased wind.

If your farts, however, are coupled with other unpleasant symptoms such as diarrhoea, constipation or cramps over a period of time, it might signify other digestive problems such as IBS.

3. There was a little bit of blood when I wiped. Is this an intestinal problem or could it be something else?

Seeing blood on toilet paper after a bowel movement can be scary, but is not always a reason for panic. There are a number of factors that can cause rectal bleeding, such as ulcers, haemorrhoids or polyps. The cause of bleeding may not be serious, but locating the source of bleeding is important.

The source of the bleeding is not always from the intestines, and contrary to popular belief doesn’t always signify cancer. How regularly does it happen? What is the amount of blood? If it’s a frequent occurrence, you need to see your doctor as a colonoscopy might be needed to find the cause.

4. Sometimes it’s sore when I orgasm. Is there a reason?

Painful orgasms can make sex unpleasant, but research suggests that it’s more frequent than we may think. The condition is called dysorgasmia and causes cramps in the lower abdomen and pelvic region as women orgasm. This condition is more frequent in older women nearing menopause.

5. I always have ingrown, fungal toenails. They’re unsightly. How can I fix them?

Ingrown toenails are already sore and prone to cause infection – add a fungal infection to the mix and it can be an unpleasant double whammy. Fungal infections in the toenails are common, but can be stubborn to treat and often reoccur. An antifungal tablet or oral antibiotic can be taken to treat of the fungal infection, while proper footcare such as trimming the nails straight across will help remedy the ingrown toenail. If the problem persists, you will need to visit a podiatrist, especially if you’re a diabetic.

6. My breasts feel lumpy and sore when I menstruate. How will I know if it’s cancer?

During your period your breasts retain extra fluid, causing the natural tissue to feel a bit lumpier. This is completely normal and no treatment is needed. You can also experience a lumpy, tender feeling in your breasts when you are on birth control, due to the hormonal changes.

Learn how to self-examine your breasts to distinguish unusual, solid lumps and always consult your doctor if you are worried. Here’s a guide on how to do a breast examination

7. I keep getting yeast infections. Is it my underwear, or is there a problem with my immune system?

Vaginal yeast infections occur when the natural yeast in the vagina starts to multiply, leading to uncomfortable itching, redness and discharge. There are several factors that could aggravate a yeast infection, including wearing sweaty gym clothes and tight shapewear, especially in summer.

While it’s not specifically the clothing that causes the condition, clothing can trap bacteria and accelerate the growth of yeast, leading to an uncomfortable infection. Stick to cotton underwear, especially during the warmer months. If this doesn’t get rid of your yeast infections, your doctor can help you investigate other underlying causes.

Readers, don’t hesitate to ask our panel of experts if you have any embarrassing questions of your own. Or you can share with us at healthnews@health24.com. 

Image credit: iStock

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Health24.com | 7 of the most expensive treatments in the world

A recent Health24 article reports how Luxturna, a first-of-its kind genetic treatment for blindness, will cost $850 000 (more than R10 million) per patient.

For the vast majority of people this treatment is so expensive that they could not afford it – even if they sold everything they own.

Backlash against medicine prices

This and other similarly expensive gene-targeting therapies are raising concerns about the affordability of medical care all over the world.

Although drug prices are regulated in South Africa, they are not in the US which means drug manufacturers can set the price as high as they wish. 

The standard explanation for exorbitant drug prices is the high cost of developing a drug, as well as the fact that so many drugs fail during trials and must be abandoned.

Some companies have, however, begun to offer more detailed reasoning as the backlash against excessive drug prices is gaining momentum.

The International Federation of Health Plans, in its 2015 Comparative Price Report, which aims to highlight the variation in healthcare prices around the world, indicates that medicine prices in the US (and UK) are considerably higher than anywhere else.

Apart from Luxturna, here are seven of the most outrageous examples of high medicine and medicine-related prices in the world:

1. Glybera

Glybera was first approved in October 2012 for familial lipoprotein lipase deficiency (LPLD), a rare genetic disorder that disrupts the normal breakdown of fats in the body. 

This drug was never approved in the US, but would have cost more than $1.2 million (±R14.7 million) per year. It will not be marketed any further in Europe by drugmaker uniQure as it has become evident that it will be a commercial failure. 

2. Soliris

Soliris costs patients up to $700 000 a year (±R8.58 million). The drug is used to treat paroxysmal nocturnal hemoglobinuria, which affects only 8 000 people in the world.

The disease destroys red blood cells, causing patients to suffer from infections, anaemia and blood clots.

3. Elaprase

Elaprase is a treatment for Hunter syndrome, a rare condition that affects only 500 people in the US. The disease is also known as Mucopolysaccharidosis type II and occurs almost exclusively in males. It is a progressively debilitating disorder that inhibits brain function and physical development.

Elaprase costs more than $500 000 (±R6.13 million) per year.

4. Naglazyme

Naglazyme costs more than $365 000 (±R4.5 million) and is used to treat Maroteaux-Lamy Syndrome, a rare genetic disorder involving the accumulation of complex carbohydrates called glycosaminoglycans in the body.

Common symptoms can include coarse facial features, corneal clouding, joint abnormalities, various skeletal malformations, an abnormally enlarged liver and/or spleen, and hearing loss. Cardiac disease and restrictive pulmonary disease can also occur.

5. Cinryze

Cinryze is a treatment for angioedema, which affects only one in 50 000 people in America. It costs around $350 000 (±R4.3 million) a year.

Angioedema is often triggered by an allergic reaction, which leads to chemicals being released into the body, causing swelling of the skin. The condition can also be caused by some medications, a genetic fault or unknown triggers.

Exponential price increases

And just as bad as high retail prices are unjustified price increases:

6. EpiPens

In August 2016 the cost of a two-pack of EpiPens (an adrenaline injection for allergy sufferers) jumped to $600 (±R7 300), compared to $90 (±R1 100) a decade earlier.

7. Daraprim

In 2015 the price of Daraprim, which is used by Aids and transplant patients, soared from $13.50 (±R164) per pill to $750 (±R9 120), which sparked a justified outrage. 

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Health24.com | You are more likely to die if this attack happens at night

In the case of cardiac arrest, an irregular heart rhythm causes the heart to stop beating. This causes sudden cardiac death if the patient doesn’t receive treatment quickly.

A new study has found that survival rates are rising for people who have cardiac arrest while in hospital.

But if cardiac arrest happens at night or on a weekend, you’re more likely to die than if it happens on a weekday.

Cardiac arrest vs. heart attack

The odds of surviving an “off-hours” cardiac arrest are nearly 4% lower than for people who have cardiac arrest in the daytime during the week, the study found.

The study was published in the Journal of the American College of Cardiology.

According to a previous Health24 article, cardiac arrest occurs when your heart function suddenly and unexpectedly stops, you lose consciousness and stop breathing. Your heart either stops completely or the rhythm becomes erratic, which prevents it from pumping blood effectively.

A heart attack, on the other hand, occurs when the flow of blood and oxygen to the heart is blocked by a clot for example, causing damage to the heart muscle. If the clot partially blocks the flow of blood in the arteries of the heart, it can cause a lack of oxygen to the heart muscle tissue called ischemia. If the clot completely stops the blood flow, then a heart attack develops.

The new study findings came from an analysis of data from 2000 through 2014 on more than 151 000 adults who had a cardiac arrest while hospitalised in the United States.

Sudden cardiac death claims the lives of as many as 2 000 young South Africans per year who are seemingly healthy, show no signs of heart disease, and who are unaware that they have an existing heart condition.

Improving survival

In that time period (2000–2014), in the US, overall rates of survival at least until discharge from the hospital increased from 16% to 25% for those who had cardiac arrest on a weekday. Survival also improved for those with an off-hours cardiac arrest, from nearly 12% to 22%. However, that was 3.8% lower than patients whose cardiac arrest occurred during a weekday, the researchers noted.

Each year, about 200 000 people experience cardiac arrest while in a US hospital, according to the study authors.

“Nearly 50% of in-hospital cardiac arrests take place during off-hours. By determining how survival has changed in recent years, we may be able to identify opportunities for quality improvement efforts,” the study’s lead author, Dr Uchenna Ofoma, said in a news release from the American College of Cardiology.

“If we can improve survival for cardiac arrests that occur during off-hours, it could impact a substantial number of patients,” said Dr Ofoma.

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