Hi @Lyn_li yes you're right, this could be arthritis and if unprovoked, the commonest cause is age-related changes in the bone and/or cartilage at the joint surface. However, there are many other possible causes that may require further examination and potentially a scan, especially if there was any injury or trigger preceding the onset of symptoms. What therapy would be effective would depend greatly on the underlying cause, and if the pain is bothering you then you may want to consider a review with your physician to determine this. Apart from the level of pain, other features that should prompt you to seek a review are the presence of any preceding injury or accompanying symptoms such as rash, hair loss, or photosensitivity (if you find your skin is unduly sensitive to sun light). Hope this helps!

Hi Victor,  this is usually a symptom of kneecap pain (patellofemoral pain). Running puts a lot of stress on the kneecap. If you are happy to modify your exercises to doing cycling and walking then that’s fine. Otherwise if you would like to return to running it would be good to get your knee checked by an orthopaedic/sports Dr to recommend treatments for kneecap pain.

Dear ozzie. You might wish to consult a urologist for neurologic bladder.. If deemed necessary, the urologist will refer to the relevant specialist for further treatment of any underlying illness. Hope this helps.

Hi @qek. Thank you for your question!

I'm sorry to hear about your symptoms as they sound quite severe. I do hope you can get an answer soon. 

The short of it is, yes, you should get it checked out usually by a OBGYN. The main purpose of further evaluation is to identify any possible secondary causes of your painful mensus (dysmenorrhea). 

Painful menus is not always due to an organic cause, but such a diagnosis of "primary" dysmenorrhea can only be made once other causes have been excluded especially in your case where this has been going on for quite some time. "Primary" Dysmenorrhea typically improves with age compared to secondary causes which tend to worsen with age. 

Secondary causes can include simple issues such as cysts or a thickened uterus lining which can be treated. 

If nothing is found, you may be given hormonal tablets to help control your mensus and reduce the pain. 

A typical check up would usually only require an ultrasound and is relatively non invasive. 

I hope this helps!

Hello @wendy . You are 54 years old and experiencing bleeding during bowel motion. You should consult your family doctor or the Polyclinic doctor. The most likely cause of the bleeding is haemorrhoids (statistically). However, the greatest concern is the possibility of colorectal cancer as the cause of your bleeding. Currently, based on the Ministry of Health Guideline of Screening of Diseases, any Singaporean above the age of 50 is recommended to screen for colorectal cancer. If the person has bleeding in the stools, a colonoscopy is recommended.

Hi @meilee. Thank you for your question!

Unfortunately this is a rather broad query and requires quite a detailed history and assessment by your doctor as to what the cause may be. In some women they have "naturally irregular mensus" i.e. no organic cause is found but if there is a problem e.g. Fibroids/endometriosis/hormonal imbalances, correcting these will often resolve your periods. 

There is medication to take to make your periods more regular but I would not suggest taking them without consulting your doctor as it can affect your fertility and if you have significant risk factors, you may not be able to take it. 

Hope this helps!

Hi @Asilamallymkun. Thank you for your question!

Based on your description it does sound like you possibly may have an anal fissure with an associated skin tag. As such, you should not be applying any over the counter medications without consulting a doctor first. I would advise you to see your doctor as soon as possible for management. Most of these conditions are self resolving and the mainstay of management involves (a) management of pain and (b) Changes to diet/stool calibre. 

While waiting for your appointment, i would suggest you start the following
1. High fiber diets
2. Over the counter stool softeners e.g. lactulose
3. Sitz bath - (sitting in a warm bath for at least 20 minutes 3 times a day) 
     > This primarily promotes anal relaxation and allows faster healing

Your doctor may prescribe you with topical antibiotics/topical analgesic medication to help relieve the pain. 

If you do develop worsening pain/increasing swelling over the perianal area/Incontinence/High fever, please do consult a doctor ASAP as these can be signs of a serious infection. 

Hope this helps! 

Hi @ravisante. Thank you for your question!

Hair loss can be quite difficult to deal with but rest assured that post partum hair loss is quite a common condition and usually self resolving within 6 - 12 months even without any form of treatment.

I would say that you should consult your OBGYN and not just start on any over the counter vitamins as many of these products contain way more Vitamins compared to what is normally required. 

For example, lactating women would only require about 35 micrograms of biotin/day. Biotin is secreted in breast milk but has a wide range of concentrations and so far there has not been much documented evidence of toxicity to the infant. 

Vitamin C/B supplements should be fine for consumption if you are unable to obtain enough from your diet. If you eat a balanced diet you should have enough of these vitamins without supplementation. Nonetheless, if you chose to take additional tabs of these vitamins, if has not been proven to cause any issues to the infant. 

I would recommend more of topical treatments such as volumizing shampoo and typically hair care products that contain biotin or silica. 

Hope this helps! 

Hi @Lynette , varicose veins is a common problem especially in women, and the occurrence increases with age, previous pregnancy, being overweight and inactivity.
Thankfully, in most cases, varicose veins is just a cosmetic issue. In more severe and longstanding cases, it may lead to pain, skin problems (eczema) and ulcers.
There are some things you can do help relieve your problem, or at least prevent it from worsening: 
- Regular exercise like brisk walking, swimming, leg gym exercises
- Try not to remain in one sitting or standing position for too long. Take short breaks, walk around, exercise your calf muscles.
- Elevating your legs 2-3 times a day, about 30 mins each time, eg while watching TV or reading a book. You can also prop up your legs at about 30 degrees angle when sleeping.
- Watching your weight , by exercising, watching your diet eg taking less carbohydrates and more fibre
- Wearing special compression stockings (these can be bought from retail pharmacies)

Doctors also give a trial of diosmin tablets (Daflon).

For persistent and troublesome varicose veins, you will then need to see a Vascular/Vein specialist for procedures like vein stripping or laser therapy.

Hi @alonso, this is a symptom of nerve dysfunction which can have either local or systemic causes. Local causes are more likely given what you describe and especially if there was a particular injury or inciting event you can recall. These include slip disc or nerve impingement. Possible systemic causes include nutrition and metabolism related diseases. The distinction is made based on your previous medical history and a physical examination, followed up with tests if needed. Based on this, my recommendation would be to see a doctor in-person for an examination, and to avoid any strenuous activities or carrying of heavy things until you do so. Hope this helps!

Hi @AmberD. Thank you for the interesting question. For ear infections, evidence supporting alternative therapies is limited. There are some suggestions that acupuncture may help with ear fluid clearance and hence resolution of ear infections, but these are merely postulations and have not been proven conclusively yet. Also, you may want to avoid ear candling, as there have adverse events reported from this practice.  

Antibiotics are indeed effective for clearing ear infections but there are side effects as you mentioned. You may consider non-quinolone based topical ear drop antibiotics (if you have no other contraindications), as this is a topical treatment that avoids the complications of systemic treatment with oral antibiotics. 

Regardless of your eventual choice of treatment, it would be best to get your infection sorted out as soon as possible, even if you do not have much pain or symptoms currently. This is because serious complications can arise from prolonged untreated ear infections such as mastoiditis etc. 

Take care and all the best!

Hi @brainyCamel521, thank you for your question. There is some ongoing research on the use of alternative therapies such as herbal medicine and acupuncture etc in the treatment of colorectal cancer, but the evidence has been limited and equivocal so far. The best advice would be to continue regular follow up with CEA and periodic endoscopic surveillance assessments as advised by the specialist. All the best and hope your family member recovers well! 

Hi @igotz99problemz , I am making an assumption that this is the 1st gynae (obstetrician) check-up for pregnancy.
Usually for the 1st obstetrician visit, a few things happen:
- the obstetrician will want to know about your medical history, any long term medical problems, current medications / supplements, any previous pregnancies, any past surgeries
- a general examination which could include checking your blood pressure, height and weight measurements, abdominal examination 
- usually an ultrasound will be performed to look at the gestational sac or early fetus to confirm the pregnancy, and based on this to, check how many weeks gestation is your baby, and thus give you the estimated date of delivery (EDD)
- some blood and urine tests may be done, depending on the number of weeks of pregnancy you are at
- you will be prescribed some supplements and vitamins, which will include folic acid
- of course, the obstetrician will have a chat with you about what to expect throughout the different stages of pregnancy, what to eat, any activities to avoid etc. So you could ask the obstetrician about any concerns you have about the pregnancy and how to look after your own health and the baby's health.
I hope this answers your question.

Hi @Me sorry to hear about this, hope you're feeling well after the laser! The human mind is very adaptive, and over time will gradually learn to "block out" the floaters. The process can take months, and is generally faster if you try not to pay attention to the floaters (difficult as that may be).

Nonetheless, given that you've seen your specialist and had the laser done, at least you can rest assured the underlying cause has been addressed. That said, if you suddenly notice an increase in the number of floaters, flashes of light, or blurring of vision, that would be an indication to arrange an urgent review with your eye specialist. I hope this helps!

Hi @ThankYou sorry to hear about your mother's ordeal! Unfortunately this is a condition she needs to seek a medical review with a doctor for early. It cannot be treated symptomatically until potential serious causes are excluded by an examination and further tests if needed. These causes include lymphedema, which can be an indication of problems affecting the lymph nodes that may progress/worsen if she delays. Please encourage her to at least go for a check up.

Hi, hypnosis is indeed a real science and some uses in fields such as pain management, psychosomatic problems etc. 

Hi @thelastblade! You have asked a very interesting question which has not actually been explored well in the scientific literature. If we go back to basic principles, the most common causes of heel pain include plantar fasciitis and achilles tendinitis. Dependent on the severity of the condition, some patients can experience heel discomfort for more than a year.

The main risk factors for these problems include prolonged walking, improper footwear and tight calf muscles. The mainstay of treatment for these conditions will include rest, a change in footwear, gentle massage to the heel and proper stretching exercises. Stretching exercises could be in the form of physiotherapy or even yoga (if the focus is on calf stretches). Whether the stretching exercises are taught through physiotherapy or yoga, the main thing is to ensure that the stretching is done properly and regularly for a sufficient duration of time.

If proper stretching exercises are not able to help, you may want to consult a healthcare professional for a reassessment. There are other forms of treatment which can be considered as well, dependent on the exact cause of your heel pain.

Hi @sickboiboi! Acupuncture is a safe and acceptable form of treatment for chronic back pain with no obvious anatomical origin of the pain. It can be used in conjunction in other forms of conservative orthopaedic treatment. 

If you have decided to consult an acupuncturist, it will be good to inform your primary treating medical practitioner that you will be starting on acupuncture treatment. All the best!

Hi @truffle2014 , congratulations on reaching 37 weeks of pregnancy! Almost there. The cervix examination is commonly done towards the end of pregnancy. The obstetrician does this to assess the condition of the cervix and see how soon the delivery will be.
37 weeks of pregnancy is considered full-term pregnancy. So you might go into labour any time from today till 40 weeks pregnancy.
Rest assured that the obstetrician will not induce labour by doing a cervix examination. Do share your concerns with your obstetrician at the next check-up. 

Hi @IvanM24 thank you for the question. Yes that is correct, knee injuries affecting the cartilage and/or meniscus can certainly present in this manner. Persisting pain despite such a long period of rest can indicate a surgery may be required, and for certain injuries,  a trial of physiotherapy may help as well. Between these options, the Orthopaedic specialist would be able to give a definite recommendation based on findings in your MRI. Hope this helps!