Health: Dear doctor

Car exhaust irritation

Q Is it possible that I have an allergy to car exhaust fumes? I'm a traffic warden and constantly have problems with itching and with hearing. I'm on my third lot of antibiotics and nothing works.

A Irritation and inflammation of the outer part of the ear (otitis externa) is very common even among people who have little or no contact with traffic fumes. Continuous use of antibiotic eardrops isn't a good idea - you may be allergic to the drops or may develop infection with antibiotic-resistant bacteria or thrush. I'd stop the drops for a couple of weeks then ask your GP to take a swab from the ear canal to see what bugs are festering there and the best treatment to polish them off. If your problem clears up while you're on holiday away from the traffic, it will add weight to your theory, though there's no single test to prove it. If the problem persists, see an ENT surgeon.

A very male problem

Q When my son was nine he had two operations to bring down his undescended testicles. He is almost 14, but I notice little or no growth in his genitals. A male hormone treatment has been suggested. Is this safe and effective? And is there any alternative treatment?

A Your son had his operation a little later than is ideal. Most specialists would advise the operation to bring down and fix the testicles in the scrotum at around two, if not before. Testicles that don't descend are more likely to be abnormal, which may imply problems in producing sperm later. Puberty, male characteristics and the ability to have a full sex life should not be jeopardised however. And huge advances in male fertility treatment should mean that even if fertility is impaired, he will hopefully be able to father children. Hormonal treatment is very rarely necessary. Ask your GP for referral to a paediatric endocrinologist before going ahead with any hormonal treatment.

Postnatal depression

Q I became very depressed when my first baby was born 16 months ago. I'm soon to have another and am very worried that the same thing will happen. Is there anything I can do?

A It is totally normal for the initial euphoria of childbirth to give way to an emotional rollercoaster about three days after the birth. By day 10, you should be knackered but happier. Postnatal depression (PND) is rarer and worse. It comes on about 4-6 weeks after the birth and can last 3-6 months. It makes you feel low, anxious about being alone, unable to cope, uninterested in everything, angry, guilty and troubled by ideas of harming the baby. Contrary to popu lar belief, it is not caused by hormonal levels. It may be linked to previous bad labour, so talk through any unresolved fears with your midwife or obstetrician. The more people you can rely on for psychological and practical support, the better. Counselling to talk about underlying depression may be useful and antidepressant drugs may be prescribed. In this pregnancy you know what to expect and will, hopefully, know to ask for help if you feel you're becoming depressed again.

For more info, try Meet A Mum (020-8768 0123) or the Association for Postnatal Illness (020-7386 0868).

Catty behaviour

Q I share my home with five beautiful cats. Someone I had considered a friend told me she thinks living with cats is unhygienic and spreads disease.

A There are thought to be considerable health benefits from having pets. Pregnant women have been told to avoid contact with cats because of the risk of toxoplasmosis. But a recent study showed that eating undercooked meat and contact with soil were the major risk factors, not contact with cats. It's true that some people are allergic to cats. But that's their problem, not yours.

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 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.

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