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What should I do to avoid heart disease?

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Dr Flo, a physician recently advised me to undergo an echocardiogram and an electrocardiogram (ECG).

What purpose do they serve and should one follow a strict regimen, that is exercise and diet, to ensure that one does not suffer from a heart ailment? Alnashir Walji

Dear Alnashir,

An echocardiogram checks the structure and function of the heart, while an electrocardiogram checks the electrical activity, function and size of the various chambers of the heart.

These tests are ordered to find out if there is any problem with your heart. This can be done due to suspicion of a heart problem, or as part of investigating other illnesses.

The purpose of the tests is to establish the state of your heart on a normal day. The tests are not harmful in any way.

To keep your heart healthy and protect it from ailments, don’t smoke or use tobacco, exercise for at least 30 minutes a day, avoid alcohol or drink with moderation, maintain a healthy weight, get enough sleep, and manage stress.

Also get regular blood pressure, cholesterol and diabetes screening, and if there is cause for concern, the doctor will recommend treatment and lifestyle changes.

Lastly, eat a healthy diet rich in fruits, vegetables, whole grains and fish; avoid too much salt and sugar and alcohol, avoid foods with saturated fat (red meat, full-fat dairy products); avoid foods with trans fats (junk food, deep-fried fast foods, margarine, baked goods, packaged snacks) and embrace healthy fats like avocado, olive oil and nuts.


Dr Flo, it has been more than a week since I had my last long call. I just go for short calls. I no longer feel hungry; I just eat lunch and supper because it is time to eat. There is no pain anywhere on my body. I am worried there might be a hidden sickness in my digestive system. Please advise me. David

Dear David,

You are suffering from constipation, which is defined as not passing stool at least once in three days, or passing dry or hard stool often, or often having difficulty pushing out stool.

It can be caused by not eating enough fibre, not taking enough fluids, being inactive for long, change of diet, stress or anxiety, and ignoring the urge to pass stool. It can also be due to a side effect of medications like loperamide, iron supplements and opioids.

Because the intestines are unable to empty normally, the appetite goes down, and if the situation continues for a while, you may start vomiting. Vomiting and abdominal pain are a sign of serious illness that would require urgent medical intervention.

To manage the problem, you need to make your stool softer by taking adequate fluids and fibre, which is found in fruits, vegetables and cereals.

Also avoid being inactive, e.g. sitting or lying down for long, and start exercising.

You also need a good toilet routine – go to the toilet at a regular time and place where you are comfortable, use the toilet when you feel the urge to, and use something to raise your legs, so that your knees are above your hips when you are sitting on the toilet.

These measures will usually work within several days, and can be maintained as part of your lifestyle to avoid a similar situation in future.

 If they do not work, or if you are quite uncomfortable, you can get short-term medications from the doctor to help you pass stool easily.

Dr Flo, I am a teenager and I have had two problems for a while now. Occasionally, my testicles ache and a clear discharge comes out of my penis. This mostly happens at night when I retire to bed. I also have pus-filled pimples on my face. They produce a solid yellowish-white discharge, followed by a clear discharge. The pimples appear on and off and this has gone on for some years now. Please help me. Worried Teen

Dear Worried Teen,

The discomfort in your testicles at night and the resulting discharge is most likely nocturnal emissions, otherwise known as wet dreams in layman’s language. This is not a problem, but a sign of normal sexual maturation.

When you reach puberty, the testosterone levels in the body rise and trigger the formation of sperms in the testicles.

These build up and are released from the body in semen when you ejaculate at night after having a sexual dream which you may or may not remember. It can happen several times a week or once every few weeks.

 If the testicular pain and/or discomfort continue during the day, you need to be evaluated by a doctor, and some tests done to check the health of your testicles.

The recurrent pimples on the face could be due to many causes, but the most common at your age is acne.

The pimples develop due to a combination of factors, which include hormonal changes (increased testosterone levels), infection and the amount of natural oily substance (sebum) produced by your skin. The pimples develop when hair follicles are blocked by sebum and dead cells. Acne is common during adolescence. The biggest problem with it is aesthetic –how you look. The resulting pimples, white heads, black marks or scars are not pleasing to look at.

To manage acne, clean your face twice a day; in the morning, and in the evening before bed and shower after activities that make you sweat a lot. Use mild soap and a gentle towel. Do not scrub your face too much while cleaning it, since it is already sensitive.

Take lots of water, and fruits and vegetables, and also exercise. Avoid skin products that may be harsh to your skin and protect your skin from the sun. Avoid pressing the pimples, as this leads to developing black marks.

Visit a dermatologist who will give you advice on medications you can use to control the acne. It may take a while before the treatment starts to work (before you start to notice changes), so be patient.

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