Penicillin and sickle cell
Q: One of our grandchildren (now three months) has been diagnosed with sickle cell anaemia, having inherited the gene from both parents. His treatment includes daily oral penicillin to ward off infection (as well as the various recommended inoculations). But I wonder how this treatment is now regarded in the light of concerns about over-use of antibiotics and suggestions that the immune system may not develop properly if it is not challenged by benign intestinal bacteria in the early months of life.
A: Your point about long term antibiotic use is well made but really refers to populations at large rather than individuals. If we all overuse antibiotics, resistant strains of bacteria tend to flourish as mutant strains impervious to antibiotics in common use proliferate. But one individual using long term antibiotics won't contribute much to the emergence of resistant strains. Your grandchild's immune system will be boosted by vaccinations and exposure to the common bugs around. The antibiotics will protect him from serious infections which could trigger painful sickle crises.
For more information call the Sickle Cell Society on 020-8961 7795 or visit www.sicklecellsoc.org.
Should I take aspirin?
Q: I'm a 62-year-old lady with no particular medical problems. All my friends seem to be taking a junior aspirin a day in the belief that it will fend off strokes and heart attacks. Should I take one too? I hate to be the odd one out.
A: If 1,000 healthy people with normal blood pressure were to take aspirin every day for a year, two or three fewer of them would have a non-fatal heart attack or stroke than if they didn't take aspirin. People with high blood pressure may be tempted to take aspirin to stave off strokes. But, in fact, it is far better to take measures to control the blood pressure. So to ward off strokes and heart attacks, get your blood pressure and cholesterol checked, but I wouldn't necessarily follow your friends on the aspirin front.
Should I work when ill?
Q: I work as an infant teacher and have felt off colour for most of this term. We're under enormous pressure to turn up for work even when ill. It's a small school and providing cover for sick teachers is a nightmare. I wonder whether I should push myself to go in even when, as last week, I had raging tonsillitis or look after myself and take a few days of as my GP recommended. Will my health suffer in the long term if I keep pushing myself?
A: Your answer comes from Sweden and may not go down well with your boss. A recent study shows that people who go to work when ill don't recuperate properly and end up taking more sick leave and feeling unwell for longer periods. The study found that teachers, nurses, child minders and carers have the highest rates of turning up to work when sick. These are also the groups that had the poorest long term health with high rates of mild depression, fatigue and back pain.
Is this feeling normal?
Q: I have the strangest feeling sometimes that I am floating. It happens a couple of times a week and I've not noticed any connection with hunger, tiredness or alcohol. I don't really get dizzy or sick but I do feel unsteady on my feet. Should I be worried?
A: If you're not deaf, dizzy or vomiting and the floating feeling comes and goes, it's highly unlikely to be anything serious. Alcohol, prescription drugs and age can all take their toll on the balance mechanism in the inner ear known as the labyrinth. Also some people with low blood pressure feel floaty when they stand up suddenly, get hot or stand for a long time.
These answers are intended to be as accurate and full as possible, but should never be used as a substitute for visiting a doctor and seeking medical help. If you have a question for Dr Robinson, email email@example.com or write to her c/o The Health Editor, The Guardian, 119 Farringdon Road, London EC1R 3ER. She regrets that she cannot enter into personal correspondence.