Apart from special features on health, our regular health column, Stethoscope will have experts from different medical  fields answering your queries. We are happy to announce that Dr. Priya Selvaraj, MD MNAMS MCE, Assistamnt Director, G.G. Hospital, Chennai will answer queries on obstetrics and gynecology and assisted reproductive technology. Send your questions by mail toe editorevestimes@gmail.com or editor@evestimesonline.com or to our office address.

I am a juvenile diabetic since the age of ten. Apart from the fact that my sugar levels go very high during the pre-menstrual period and dips suddenly the day my periods begin. I get severe stomach cramps and breast pain. Earlier, during my teenage years ( now I am 21) I used to have hypothyroidism for which I took eltroxin. Now my thyroid levels are normal but sugar control is not very good as I am stressed out due to the burden of my studies and now my job. More over, I have severe mood swings before my periods and this has cost me heavily in terms of my relationships with friends and relatives . I really don't know how to handle every menstrual cycle which is now causing panic in me. How to go through every cycle smoothly, with less pain and more specifically with no pre-menstrual mood swings?
 
   Since you have been diagnosed quite early at age 10, I am sure your family has been supportive and so have your friends, both at school and workplace, so you owe it to them to keep yourself healthy and not buckle under pressure. Please understand that just as work is worship so is your body. These days there is hardly any distinction between adult onset and juvenile diabetics because stress levels and the inability to cope with it are pushing more and more youngsters to developing it at an earlier age. The first step is to get in touch with a good diabetologist who can bring your sugar under control with the right doses of insulin. Please recheck your thyroid status if it has been over 6 months to a year since the last blood test. The fluctuating blood sugar levels may be related to the premenstrual syndrome itself in the form of dietary preferences rather than to insulin levels. Please follow a prescribed dietary and fitness regime. Considering your inadequate blood sugar control, hormonal pills may not be the option at present; however you may take multivitamins everyday and a combination of vitamin E with evening primrose oil for 2 weeks prior to menses. Severe cramps can be overcome with antispasmodics but it would be worthwhile to follow up with a gynecologist. Stress management is essential and please make sure you take help even if it means meditation or a visit to the psychiatrist/psychologist.
 
 I am a working woman, 23 years. I am about to get married. I don't want to get pregnant immediately after marriage because I would like to settle down in my career first. I would like to know which method of contraception will suit me the best. My best friend who got married recently is having problems with IUD . She says that her bleeding is heavy and she gets severe cramps during her periods. I am very sensitive to pain and I don't want to undertake this. As for oral contraceptives, two of my aunts had breast cancer, one of whom passed away. I have read somewhere that if there is an incidence of breast cancer, it is best to avoid oral contraceptives. I have never been to a gynec before and I feel shy to talk about this to anyone, including my mother. I cannot discuss this with my fiancé because it is an arranged marriage and only now I am getting to know him. I am confused. Is there any help at hand?
 
There is help at hand. First of all having 2 second degree relatives with breast cancer does pose a slightly increased risk compared to general population. If you are unaware of anymore cases in the family please make it a point to find out and if there are more, it is possible to assess your risks by appropriate genetic counseling and testing. In general it is better for you to be aware about risk factors related to the disease such as conditions that allow our normal natural hormones (estrogen) to act for a long time in our body on female target organs like breasts, uterus and ovaries without a break namely, early menarche and late menopause, postponing childbirth or not having children at all. Visit a gynecologist as awareness is more important and you must learn the techniques of self breast examination which can be easily performed even during a shower. Intrauterine device for women who have not completed at least one childbirth should be preferably avoided. I would recommend the use of condoms or low dose oral contraceptive pills such as novelon or femilon but would still advice you to have a personal consultation first to assess risk status and advice on future fertility.

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STETHOSCOPE

Stethoscope, our regular health column will bring you a lot of information on health care issues, counseling and advice from doctors in different fields. You can send in your queries to doctor@evestimesonline.com So make the most of it!

My wife is a juvenile diabetic. She is a is a good person and is dynamic and active. It was a love marriage and she is very much devoted to me. However she is very much prone to mood swings. Is this common among diabetics? When she becomes emotional her sugar goes high. How do I handle her?

Great advances have been made in diabetes research. If you are a diabetic, you can lead a life similar to anybody else. Your normal capabilities should not be affected if you make a concerted effort to implement certain changes in your lifestyle. Remember, unless you make up YOUR mind, no doctor or medicine or treatment procedure can help you. First and foremost, equip yourself with knowledge about diabetes and diabetic care. Once that is done, along with your doctor’s counsel, you can lead  your every-day life meaningfully.

The word, ‘Diabetes’ comes from the Greek language- meaning ‘ to pass through,’ and mellitus means ‘sweet.’ Diabetes mellitus is thus  a metabolic disorder when the sugar from the food is no longer adequately utilized because the production of the hormone insulin is deficient, non- existent or is non functional. The unused sugar is excreted in the urine. In adult diabetes or Type 2 diabetes, the primary factor for the malfunction of the pancreas that produces insulin  apart from heredity is overweight. In Type 1 diabetes that happens to children, the initiating factor can be puberty or episodes of rapid growth.

The sooner you approach a doctor when you observe the first symptoms of diabetes, the greater is the chance of postponing diabetes related complications.  Uncontrolled sugar for a long time leads to complications that will affect the eyes, kidneys, heart and blood vessels and nerves. By leading  a monitored and  disciplined, you can avoid these complications.

To tackle diabetes, you have to take care of the following:
Proper Diabetic Diet
Insulin or medicines
Exercise
Proper instructions from doctor and awareness
A Disciplined way of life.

To be Continued…