ASK THE DOC
Frequent pain
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Advice from our panel of doctors in response to our readers' queries.
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Name withheld:
My daughter (11 years) has frequent joint pains. She also has pain in the shoulder blades and jaw (at joint), which sometimes spreads to her head. A blood test for RA factor was negative. She is tall and bony but of normal weight. She does not have spondylitis. One ortho-specialist said she might have a extra rib (cervical rib) that causes pain. Please suggest a cure.
Dr. Prema Shankar, Consultant Paediatrician, replies:
Your daughter's symptoms are very varied and do not fit into any classical picture. She would therefore require a detailed history taking and physical examination, which should include her height and weight, especially as she is in the pre-pubertal stage. Blood tests and X-rays to rule out musculo-skeletal, connective tissue and haematological disorders, will have to be done. These will have to be analysed by a Paediatrician and a diagnosis arrived at and only then a suitable medication/treatment can be given.
Hallucinations
Name withheld:
My Mother — 53 years old — has a strange problem. She says someone talks to her and uses her hands to do work. This has been happening for15 years. She was on medication but became very drowsy. Right now she is taking Sizopin 100, Rispond 2mg, beplexforte, Noc20. After decreasing the tablets she has a relapse. Is there a permanent cure?
Dr. Seshadri Hariharan, Consultant Psychiatrist, replies:
The experience of someone talking to her when no one is around is what is called an auditory hallucination. The feeling that someone is using her hands to do work is an abnormal belief referred to as a delusion. Delusions and hallucinations are typically seen in patients with schizophrenia.
This illness is due to over activity of a chemical called dopamine in the brain. Medicines such as Sizopin (clozapin) and Rispond (risperidon) which she is taking are given to block the over activity of Dopamine. Generally about 25 per cent of patients make a complete recovery, another 25 per cent do badly and the remaining half does moderately well.
As your mother has been ill for about 15 years, complete recovery or permanent cure appears very unlikely now. However, as she relapses only when medicines are reduced she can remain well with regular medication. Therefore, she should take her medicines as prescribed by her doctor under close psychiatric supervision.
Please continue to write in to "Ask the Doc", Sunday Magazine, The Hindu, 859-860, Anna Salai, Chennai - 600002, or e-mail magazine@thehindu.co.in
Keep your queries short and focussed. Please do not enclose your medical records. Please mention your name and postal address and whether you'd like your name to be mentioned.
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