Dear doctor

Emergency measures

Q: My mum is very unwell with bowel cancer. She is coming home from hospital tomorrow and we want to get an alarm for her which she can press if she is in trouble. Where can I get hold of one?

A: Alarms are a great idea for anyone who is frail and living on their own. BT (0800 671 504) offers a service called In Touch, which provides a red panic button to wear on a pendant round your neck or on a watch strap. Pressing the panic button activates your phone to dial three pre-programmed numbers in turn until it gets a reply. It costs around £129 for phone and pendant. Asap (the association of social and community alarm providers, 01634 304 200) is an organisation with a list of local authorities and social services that provide various types of personal alarm systems. Most of these provide a panic button that activates a call to a local centre. They can send an ambulance, call a relative or send someone round if you leave your keys with them. These systems can be cheap or free if you're on income support. Otherwise they cost around £170 for installation and £85 a year thereafter. Age Concern (020-8679 8000) and Help the Aged (020-7278 1114) can also offer advice about alarms.

An embarrassing itch

Q: I have a horribly embarrassing problem. My vulva is intensely itchy and I have to rush to the loos at work to scratch, which is making me so sore I can hardly sit down. At night, I've been clawing away and have made myself bleed. I can't even think about having sex, it's so sore. I had a look with a hand mirror and can see some purple-looking spots. I was given some cream for thrush which didn't work at all and a swab came back as clear. Can you help?

A: You may have lichen planus. It's a skin condition that causes itchy, purple spots on the "lips" around your vagina and can also affect skin, hair, nails and mouth. No one really knows the cause but it's probably one of those auto-immune conditions in which your body attacks some of its own cells. It usually clears up on its own within two years, leaving brownish spots like freckles as an everlasting reminder of your agony. I wouldn't advise you to scratch and suffer in silence. You can see a dermatologist, who will take a small biopsy of the sore area if the diagnosis is uncertain. Treatment includes KY jelly to reduce friction, steroid creams and antihistamine tablets to lessen the itch. It almost never becomes cancerous or gives you any long-term problems.

How to quit smoking

Q: I truly want to stop smoking. I have been offered a rather overwhelming range of options: leaflets, counselling or a prescription for the anti-smoking drug Zyban. Now I gather I can have patches on the NHS, too. I've set myself the date of June 1 to stop. Which method is most likely to help me?

A: Your resolve is your strongest and most dependable ally. You're ready to quit, you've set a date, you have sought help; you're well on track. Nicotine replacement therapy (NRT) gives you a nicotine crutch without the other harmful chemicals in a cigarette. It'll help fight the urge to smoke and the withdrawal symptoms. Your chances of successfully quitting (ie staying away from fags for at least six months) doubles with NRT. You can't take it if you are pregnant, breastfeeding or under 18, have had a heart attack in the past month or have uncontrolled high blood pressure. It comes as patches, lozenges, nasal spray, inhalator or gum; though gum is probably the least effective and patches are the most tried and tested. NRT is best used for at least three months. Zyban is an antidepressant drug with the same success rate and effects as NRT, although no one is sure how it works. If you are an alcoholic, have epilepsy, are pregnant, breastfeeding or taking one of a number of drugs that act on the nervous system, you can't take Zyban. A full course lasts for eight weeks and you start it eight days before quitting. Counselling, helplines, support groups and so on may all help but if I were a smoker trying to quit, I'd also take Zyban or use a patch; it's hard enough even with the props.

Thanks to guardian.co.uk who have provided this article. View the original here.