Can I treat my kids?
Q I always take homeopathic remedies and now have two small children whom I would like to treat similarly. My partner says that this is irresponsible and that I don't know for certain that homeopathy is safe or effective.
A Diagnosing and treating one's own children is not a good idea. The General Medical Council has warned doctors against treating their own families because it is hard to be objective with those you love and because of the guilt if you get it wrong.
Apart from coughs and colds, avoid dosing your kids with over-the-counter homeopathic, herbal, Bach flower or conventional remedies. There is no comparison between a long and detailed consultation with a trained and experienced homeopath, resulting in a prescription for a customised concoction, and buying a bottle off the shelf. Because homeopathy uses very diluted substances, the chances are it's safe. But we are buying a lot of homeopathic remedies - £25m a year in the UK - and have no way of knowing whether side effects are occurring or not. It is safer to treat your children with homeopathy than anything else, but safer not to treat them at all.
Relief for sciatica
Q Please can you tell me if there is any treatment for sciatica that would reduce severe pain. My sister, aged 79, has suffered for about 15 years and can only take a few steps before pain brings her to a halt. Her GP just gives her painkillers which don't help. Apart from high blood pressure, which is kept down by the usual drugs, she is in good health and cannot bear this life as a semi-invalid.
A Your sister should not be condemned to spend the rest of her life in pain. The first step is to confirm the problem. An interested GP can arrange blood tests, x-rays and a bone-density scan, or refer your sister to a rheumatologist. The chances are that she has osteoarthritis and possibly a slipped disc pressing on her sciatic nerve. But there are other causes of back pain, such as osteoporosis, which, if treated, may prevent further back problems or fractured bones.
For ongoing backache, back exercises can work wonders - a physiotherapist can show your sister what to do. She should try to stay active, keep her weight down and look into exercise classes in water if she can get in and out of a swimming pool. Counselling in ways of dealing with pain psychologically helps some. Manipulation by an osteopath, chiropractor or physio is a good idea. The rheumatologist may offer an injection of steroid and local anaesthetic into the most painful spots which helps 60-80% of sufferers.
Q From time to time and for no apparent reason, my heart will suddenly jolt and race upwards so that it feels as if it is going to fly out of my mouth. Before my alarm really registers, I give a cough and it settles down. It is as if it had missed a beat, floundered a moment then scrambled to catch up again. I feel a bit wary of this unpredictable beast in my chest, then all is forgotten again.
A You give an excellent description of extra or ectopic beats. Although it feels as though you are missing a beat, it is actually due to an extra heartbeat followed by a prolonged period of resting by the heart. An extra beat every so often may be disconcerting, but is not usually part of a dangerous condition. An ECG can distinguish between the different patterns of extra heartbeats and other disturbances of the rhythm of the heart.
The harmless type you have is known as extrasystole. This can be exacerbated by stress and caffeine, and gets better when you exercise. If it is causing you concern or discomfort, you could see a cardiologist who may order other tests such as a 24-hour ECG which is more likely to capture a recording of the rhythm disturbance. Reassurance and caffeine avoidance are usually the only treatments.
Is this Epstein-Barr?
Q I recently had a nasty case of shingles on my face and then developed swollen glands in my groin. Could I have EBV?
A EBV (Epstein-Barr virus) causes glandular fever which is common in young adults. It can cause swollen glands everywhere in the body (neck, armpits, groin) and enlarge the liver and spleen causing stomach pains. Usually, it makes you feel washed out, and feverish, and causes a sore throat.
Glandular fever is spread by droplets in the air or saliva and is easily caught through kissing - it is sometimes called the kissing disease. A simple blood test (Monospot) is used to diagnose the infection. It is possible that you have had glandular fever for a few days and the that shingles developed because your immune system was run down as a result. There is no treatment for glandular fever other than rest and avoiding alcohol. Most people make a full recovery within a couple of weeks.
· 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 firstname.lastname@example.org 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.