When I place my right foot on the ground in the morning, I have acute pain. After an X-ray, the doctor says I have a calcaneal spur.

Calcaneal spurs can occur in anyone with increasing age, especially if obesity has also set in. Consult a physiotherapist to learn the stretching exercises. Try doing these regularly. Always wear soft-soled footwear, even in the house. A few sessions of ultrasound treatment may also help. Mild non-addictive anti-inflammatory agents and painkillers like paracetamol and ibuprofen may lessen the pain. If there is no relief after 6-9 months, you might want to consider surgery.

Hirsutism

I suffer from PCOD. I have irregular periods and am very hairy. Waxing and threading my face regularly is a pain. I was given diuretics but I am reluctant to take them.

I think you mean the diuretic spironolactone (Aldactone). Although spironolactone is usually given for hypertension and heart failure, in doses of 100-200mg a day, it is effective against the androgenic effects of PCOD. It helps reduce hirsutism. It can be given alone or combined with oral contraceptive tablets.

Cracked feet

I have feet that are ugly, cracked and fissured.

If the cracks are nasty, it may be worth going to a beauty parlour to smoothen the heels initially. Repeat the treatment once a month.

Once all the deep cracks have been removed, you can maintain beautiful feet by soaking your feet in hot water to which rock salt and a few drops of liquid soap have been added. Take a soft plastic brush and scrub the heels and feet gently. Then apply liquid paraffin. If you do this at night, you can wear a pair of cotton socks to hold the oil and moisture without staining your sheets.

Artificial sweeteners

I wish to use artificial sweeteners to prevent diabetes and keep my weight under control. Are they safe?

Some studies in the Seventies showed that saccharin use was associated with bladder and other cancers but new studies have disputed this. Many artificial sweeteners are considered generally safe, even in pregnant women. Stevia and tagatose are new artificial sweeteners with few side effects. However, all artificial sweeteners can have a laxative effect and cause bloating, abdominal distention, pain and diarrhoea in some individuals.

Milk allergy

I develop bloating, pain and diarrhoea if I drink cow milk. My doctor told me to drink soya milk instead.

You are probably deficient in the intestinal enzyme lactase, which breaks down the lactose in milk. Sometimes you might be able to tolerate the small amounts of milk in tea or coffee but be unable to drink a whole glass of milk. You might be able to handle curd. Soya milk does not contain lactose, so you can tolerate it.

Coffee trouble

I need a cup of coffee to function in the morning, but it immediately makes my stomach ache.

Some people are unable to tolerate coffee on an empty stomach. It can aggravate acidity and produce a gastro-colic reflex that causes cramps and makes you urgently want to go to the toilet. Try eating a biscuit or having some other snack before drinking the coffee.

Insomnia

I can’t fall asleep or stay asleep. Mybody pains continuously.

Consult a physician and get blood tests done for anaemia, diabetes, thyroid functions, Vitamin D3 and Vitamin B12 levels as well as for electrolytes (sodium, potassium, magnesium and calcium). The cause of these symptoms might be found after proper physical evaluation and blood tests. Appropriate treatment can then follow.

The writer has a family practice at Vellore and is the author of Staying Healthy in Modern India. If you have any questions on health issues, please write to yourhealthgm@yahoo.co.in