Ask Dr. Mallika!
Have a question? Experiencing some unusual ache in your side? Is it feed a cold/starve a fever, or vice versa? Ask Dr. Mallika! Please be as specific as possible when describing pain or symptoms.





I’ve been coming down with a bad case of laryngitis every 3-4 months or so. Is this something I should be concerned about, or are some people just more susceptible to it?

Kim in Marlborough

When someone develops laryngitis, they have swelling or inflammation of the voice box which contains the vocal cords. Swelling of the vocal cords can cause hoarseness or the loss of voice. Most cases of laryngitis are caused by viruses, like the common cold, but laryngitis can also be triggered by allergies, acid reflux (heartburn), irritants like tobacco smoke, chemicals, and direct injury to the vocal cords from loud yelling or screaming.

If you are having recurrent bouts of laryngitis, it is certainly possible that you just keep getting sick with a different cold virus. But if your laryngitis is not associated with other cold symptoms like runny nose and cough, there may be another trigger, like an environmental allergy. Try to keep track of what’s happening in your life next time you get a bout of laryngitis to see if you notice any patterns, and then give your doctor a ring.


I’m hearing a lot about the new diet fad with African Mango supplements. Have you heard about this? I know diet and exercise is a staple, but what about adding this on in addition? By the way, love your segments on NECN.

Fat in Boston

The African Mango tree, technically known as Irvingia gabonensis, grows in West Africa. The mango-like fruit has seeds which are thought to have medicinal properties. Some small studies suggest the extract from the seeds may help people who are overweight lose weight, especially if combined with a low-calorie diet, but these studies were not considered high quality. The extract may also help improved cholesterol levels in overweight patients. More research is needed to evaluate both of these claims further.


I was diagnosed with 4 blocked arteries in the lungs (pulmonary emboli) in 9/2007.  Ever since then I have been on the blood thinner, warfarin.  Initially, they told me I would only need to take it for 6 months.  Then they  told me I would have to be on warfarin for the rest of my life.  I can’t seem to get a straight answer from any of the doctors I have seen.

Anthony

One reason you may be getting different answers from different people is that there isn’t a hard and fast rule when it comes to how long patients with a pulmonary embolism should be treated.  In general, for patients who develop a blood clot in the lung for the first time and it’s pretty clear why they did, that is they’ve had recent surgery or they have been immobile for a long period of time, treatment with blood thinners may only be necessary for three months or so.  For other patients who have developed a pulmonary embolism for unclear reasons or for patients with recurrent pulmonary emboli, longer treatment is often recommended.  And if you’re not at higher risk of bleeding while taking blood thinners, some experts will recommend you stay on blood thinners for life.  I would have a frank conversation with your primary care doctor about your concerns and come up with a treatment plan together.  Good luck.

I’m 46 years old and have been experiencing pain in my right rib cage. It comes and goes. What might be causing this?

William from Rockport

One of the most common causes of rib pain is muscle strain or inflammation. There are muscles in between your ribs which help you expand and contract your chest wall while breathing. These muscles can become strained or inflamed like any other muscles in the body. The pain is usually worse when you touch the affected area and hurts more when you breathe or cough. It’s usually not dangerous and can be treated with anti-inflammatory medications. If the pain is in the center or left side of the chest or is accompanied by shortness of breath, cough, nausea, or palpitations, you need to be examined right away.


Does garlic really lower your cholesterol?
Babs from Charlestown

Garlic has been hailed in recent years as a way to fight high cholesterol, but the data are conflicting. A few studies have shown that taking garlic tablets leads to a modest reduction in cholesterol but others have found no long-term effect. They say more research needs to be done in this area and for now, stick with it as a savory spice.


I’ve heard that breastfeeding can reduce the risk of breast cancer. Is this true?
Linda from Woburn

Several studies have shown that breastfeeding does, in fact, have a protective effect against breast cancer. Research also suggests that for every twelve months you breastfeed, you may be able to reduce your risk of breast cancer by about four percent, and lower your risk by about seven percent every time you give birth. It’s thought that breastfeeding leads to hormonal changes that offer some protection against the growth of breast tumors.


I’m experiencing pain in both of my lower legs. I’ve been walking several miles a day for the past week. I don’t recall injuring myself during the walks, but yesterday developed significant pain in my shins. Suggestions?
Ryan from Southborough

It sounds like a case of shin splints, a common cause of lower leg pain after certain types of strenuous activity, especially running. They occur when the lower legs become overstressed, leading to small tears in the leg muscles where they attach to the tibia or shin bone. Most shin splints can be treated by resting the legs, applying ice for 15 to 20 minutes several times a day, and by taking over-the-counter pain medication like ibuprofen. Shin splints can take several weeks to heal. Stress fractures can also cause pain in the shin after intense exercise but the bone itself is usually tender. These too, however, usually heal with rest, ice, and pain relievers over a 4 to 6 week period. If the pain is severe or persists for more than a few weeks, you may need to be seen by an orthopedic specialist.


What exactly is whiplash?
Ruthie from Boston

Whiplash is a common name given to sprain of the neck or the cervical spine. When most people think of whiplash, they think of a car crash. But it can occur with any injury which places excessive stress on the ligaments in the neck. Symptoms include pain, stiffness, muscle spasms, and headache. Turning or twisting the neck usually causes pain, so immobilizing the head using a soft neck collar, like what you see in the movies, can help. Ice followed by heat and anti-inflammatory medications can also relieve pain. Most neck sprains heal within 2-6 weeks.


My 11-year-old son developed a rash three days ago. It started with a few bumps on his arms, but now has several on his legs and face. He says they itch a little, but not much. Aside from the rash, he’s been well (no cough, fever, sore throat, vomiting or diarrhea). He hasn’t used any new soaps, detergents or clothing and hasn’t eaten any unusual foods. He spent the night at a friend’s house a few nights ago, I’m wondering if he might’ve picked something up?
Julie from Ashland

This sounds like a possible case of bedbug bites. Bedbugs don’t spread disease but can be a nuisance. Some people, if bitten, don’t develop much of a reaction at all, but others can develop intense itching and an allergic response. The bites usually appear as small red bumps that often occur in a linear pattern but can grow to large red welts in some people. To find out whether you have bedbugs in your home, look for the tiny white or brown-colored bugs in the seams of mattresses. Or check for tiny bloodstains or insect waste on the sheets. To get rid of them, you need to clean your home thoroughly…wash all bedding and clothing in hot water, vacuum carpets and cracks in the wood floors, get rid of infested mattresses and box springs and consider using an insecticide. You can check with a hardware or pest control company for further advice. You should treat the bites with Benadryl (diphenhydramine) and an over-the-counter hydrocortisone cream. If the bites begin to look infected with increased redness, warmth, and tenderness…see your doctor right away.


If you have small fibroids in the uterus can you still carry a pregnancy? I had a previous miscarriage and am concerned.
Madison from New York

It really depends on how large they are and where they are located in the uterus. Large fibroids that protrude into the uterine cavity can certainly affect fertility and lead to miscarriage. But miscarriages can be caused by a number of other things as well. So if you’ve only had one miscarriage, and you have been told by your doctor that your fibroids are small, they may not be a factor at all. But obviously you should check with your doctor to see if they recommend removal of the fibroids before you try to get pregnant again.


Our 2-week-old baby has been warm to the touch for the past 2 days. We haven’t taken her temperature but are pretty sure she has a fever. She has a runny nose and a dry cough. She’s eating well and is awake and alert. Is the fever serious? Should we bring her to the doctor?
Brad and Kelly from St. Paul

Fever is part of the body’s normal defense against infection and is almost never dangerous. Most children who develop fevers have minor infections like a cold, an ear infection, or a throat infection. But in young babies, who by nature have lower immunity, it is important to make sure that there isn’t a more serious bacterial infection in the blood (bacteremia), the urine (urinary tract infection), or in the fluid that surrounds the brain (meningitis). While the majority of newborns with a fever have a minor viral infection, about 12 percent are found to have a serious bacterial illness. A baby less than one month of age with a fever greater than 100.4 rectally needs to be evaluated in an emergency room for blood tests, urine tests, and a lumbar puncture (spinal tap). A chest x-ray may also be performed if there’s concern for pneumonia. The baby is also often admitted to the hospital for observation and intravenous antibiotics until the culture results become available in 48 hours or so. If all of the test results are reassuring, the baby can be discharged home.


I’ve heard that margarine is just as bad as butter when it comes to your cholesterol. Is that true?
Judy from Wellesley

Without a doubt, saturated fat, like butter, is bad for your cholesterol. But as you know, recently, another type of fat has come under attack. Trans fat is created when a liquid fat is hardened through a process called hydrogenation. Trans fat can also raise your cholesterol, though not as much as saturated fats, and should be avoided when possible. In the past, many margarines contained trans fat. Now there are several brands that are trans fat free. So if you want to buy a spread, look for a soft tub that lists liquid vegetable oil as the first ingredient and that clearly states it contains “no trans fat”s.


Can fitness help improve your sexual performance?
Joshua from Newton

Absolutely. Regular exercise not only helps keep you physically fit but improves your libido as well. If you stay in shape, you’ll certainly feel better about yourself and have a better self-image. And not only that, according to the American Council on Exercise, by optimizing blood flow, exercise can have a natural Viagra-like boost and help with erectile dysfunction.


My husband says the bottoms of both feet hurt like the dickens. What could it be?
Barbara from Barnstable

Foot pain is quite common and can be caused by a number of conditions. Plantar fasciitis typically causes heel pain that is worse in the morning and gets progressively better as the day goes on. It’s caused by inflammation of the band of tissue that rests on the bottom of the foot. Another common cause of foot pain is neuropathy in which the sensory nerves in the feet become damaged causing a burning sensation. Diabetes is the most common cause of neuropathy in the feet and may occur even before the diabetes is diagnosed.


My normal temp is around 97 degrees. If it climbs to 99 or 100, is it any more of a fever than a person with a normal temp of 98.6?
Linda from Dorchester

First of all, a body temperature of 97 degrees is normal. The average oral temperature is actually about 98.6 but can vary by a couple of points depending on the person, activities, and the time of day. For example, your temperature tends to be lowest in the early morning and highest in the afternoon. And regardless of what your particular normal temperature is at any given point, a fever is still generally considered to be 100 degrees or above when taken orally.


My husband wants me to slow down at the end of my treadmill program. I don’t feel it’s necessary. What do you say?
Margaret from Natick

It’s probably a good idea to do some type of cool down routine at the end of an exercise program. For example, if you’ve been walking on a treadmill, you might walk at a reduced speed for several minutes at the end, which gives your breathing and heart rate a chance to slowly return to normal. Stopping too suddenly can sharply lower your blood pressure and may cause muscle cramping. Experts say you should slow down your activities until your heart rate is about 10-15 beats above your normal heart rate.

© 2017 © 2010 Dr. Marshall Enterprises LLC | Privacy Policy