I got bitten by a stray dog and had to take the anti-rabies vaccine. When can I take my Covid-19 vaccine?

You will have to wait for 28 days after the last dose of the rabies vaccine.

Knee replacement

I have pain in both the knees, more on the right than the left. I want to go in for knee replacement.

Knee replacement is a major surgery, not to be taken lightly. It should be the last resort. First try to lose weight and reach your ideal BMI (weight divided by height in metre squared so that it equals 23). Attend physiotherapy sessions and do knee strengthening exercises. Have heat, cold, interferential therapy and other modalities for pain relief there. Try these for six months. If this doesn’t help, then surgery is your only option.

Warts

I have ugly cauliflower-like soft, black growths on two places on my skin.

They sound like warts, which are caused by a virus. They can spread from one area of the skin to another and also from person to person via contact. There are no oral medicines, they need to be tackled by a dermatologist. Local applications are used at times; otherwise, they may be frozen (cryotherapy) or removed using a cautery or laser.

Bloody stool

I pass bright red blood with my motion, which is also hard and painful.

You need to see a doctor. It might be due to haemorrhoids (piles) or a fissure, but it can also be due to some less common conditions like polyps, diverticulosis or inflammatory bowel disease. Bleeding can make the stool black if it is not fresh blood. Black stools happen due to bleeding from high up in the gut, such as from the oesophagus, or bleeding ulcers. It can also be a symptom of colon cancer. In any case, it needs evaluation.

Kidney problems

I have pain in my right hip. I have been taking painkillers for many years. I have developed swelling of feet and albumin in the urine. The doctor says it is because of the painkillers.

Painkillers whose names end in “lac” are effective but if taken for more than a week, they affect the kidneys. Paracetamol is safe, has fewer side effects. The liver is affected if very large doses are taken. A combination of medicines can give relief. Then the dosage of any one is lower. Side effects are, thus, less likely and less severe. External applications of gels, particularly those containing capsaicin, are also quite effective.

Spoon-shaped nails

All my friends have nails which are round. Mine are curved inward like a spoon.

One of the commonest causes is iron deficiency. Check your haemoglobin levels. If low, start taking iron supplements. The nails will become normal in a few months.

Tired always

I feel tired all the time. All blood test results are normal. I drink a glass of glucose or coffee to perk myself up, but it doesn’t help.

If the tests are normal, drink a glass of plain water when you feel exhausted and then walk around the room for five minutes. The calf muscles will release chemicals that elevate your serotonin levels. Glucose and caffeine boost for a few seconds only. After that you’ll be more tired than before.

Menstruation

Can I take the Covid-19 vaccine when I am menstruating?

Yes, you surely can. Menstruation is not a contraindication to the vaccine.

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