My son walks on his toes all the time. Is this normal?

Children sometimes walk on their toes but this usually corrects itself by the age of three. Habitual toe-walking after this age needs to be evaluated by a physician. It may be a mechanical problem because the Achilles tendon, which attaches the heel to the calf, is too short. It could be a problem in the muscles like with cerebral palsy or muscular dystrophy. It is common in autism.

Regular dose to beat blues

I have been prescribed antidepressants but I don’t like taking them regularly. Why can’t I take them only when I feel down? They make my mouth dry and I feel drowsy during the daytime. Can I take herbal supplements instead?

When you take antidepressants, you know the exact chemical composition and the dose that you are taking. With herbal supplements that is not the case. The exact amount in each teaspoon or tablet is not known. Medication for depression has to be taken regularly whether it is modern or herbal medicine. The levels of medication have to slowly build up in the blood. It is not like a sleeping tablet that you can take once or twice, whenever needed.

Perhaps you could speak to your doctor about the side effects of the medication. He might change it for you. Mild depression can sometimes be tackled and the dose of medicine reduced by adding psychotherapy, counselling and regular aerobic exercise.

Knee replacement

I have been advised knee replacement for osteoarthritis of the right knee. I am 55 years old.

Younger people like you are being advised knee replacement but it has to be a very individual decision made by the patient and the doctor. A replaced knee lasts between 15 and 20 years. After that, you may need to get them replaced once more. If you wait too long, the knee may be so damaged that the surgery may become more difficult technically. Before opting for replacement, try weight loss, physiotherapy and strengthening exercises.

Blood test results

Some blood tests were done on my 10-year-old daughter as part of a master health check-up and many abnormal results were found.

Results in healthy children, especially tests for liver functions, inflammatory markers and the lipid profile, can be inaccurate. You cannot evaluate health with blood tests alone; a physical examination also needs to be done.

Scratch that itch

My nipples are itchy. I feel like scratching them even in public.

This may be because winter has caused your skin to dry. Your bath soap or the detergent you use may be causing an allergy. It is common during pregnancy and in breastfeeding mothers. Itchy nipples can also occur because of friction with clothes or be part of eczema. Sometimes, it is due to a precancerous condition such as Paget’s disease of the nipple. It is better to get it evaluated.