q I am two months pregnant and have a poor appetite. I dislike the look of most food. My mother says I should eat for two.

The body changes a great deal during pregnancy. New hormones are released and the levels of already existing hormones change. This can cause your symptoms.

Try walking in the fresh air (if there is no contraindication) for 30 minutes in the morning and the evening. Eat what you like and feel like eating. Vanilla ice cream is usually enjoyed even during pregnancy. If you actually vomit more than five to seven times a day, inform your doctor.

Exercise limit q I am 60 years old. How much should I exercise to stay healthy?

The recommendation is 150 minutes of activity a week, which is around 30 minutes five days a week. For good health, add at least two weight training sessions with 2 or 5-kg dumbbells. This will prevent sarcopenia or muscle wasting. At least twice a week, you also need to do flexion and balance exercises. Yoga and tai chi are excellent options.

IBS and diet q I have been diagnosed with IBS. Are there any dietary changes I can make?

Many patients benefit from excluding milk and wheat from their diet. Try this and see if your symptoms improve. Regular aerobic exercise helps.

Chest pain q I have chest pain on exertion. I cannot walk more than 50 meters. What medication can I take?

It might be worthwhile to consult a cardiologist. He or she will perform tests like an ECG, echocardiogram and a treadmill to determine your effort tolerance. Several medications can be started to improve your heart function. You might be a candidate for a stent or bypass surgery.

Itchy skin q The skin on my legs itches uncontrollably. Sometimes, I scratch so much that the skin gets excoriated, bleeds and pains.

This may happen if the skin is dry or the legs are swollen. Bathe using a moisturising soap. Put a tablespoon of coconut oil in the bath water. Pat your skin dry after a bath. Apply liquid paraffin to the legs after the bath.Take a mild, non-sedating antihistamine like levocetrizine. If it still itches, wrap an ice cube in a plastic bag and gently rub it over the affected area. Consult a doctor to see if there is any remedial cause for the itching.

Muscle cramps q My leg muscles go into severe cramps at night. I wake up in agony.

For immediate relief, passively stretch the limb and hold it in the stretched position for 30 seconds. Apply ice. For permanent relief, figure out why this is occurring. Check for diabetes or kidney or liver disease. Check your electrolytes. Low levels of calcium or magnesium can cause this. You may also be deficient in Vitamin d3.

Frothy urine q I noticed that my urine froths in the toilet and also stinks. I have no other symptoms.

Frothy urine may mean there is albumin in it. This can be easily tested. A foul smell may be caused by a urinary tract infection or even pills you take. Even an excess of multivitamins can cause a foul smell in the urine.

Pain relief q I often have aches and pains and buy medicines like aclenofenac, ibuprofen and paracetamol.

There are many different medications for pain relief. Some work only for a few hours. Frequent dosing may be needed. When used long-term, they all have side effects. Do not self-medicate with painkillers for more than three days in a row.

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