How can I heal the muscle injury in my thigh?

Dear K.A.B, Ugandan footballers believe they sustain injuries because someone wants their position on a team, and therefore will not see a conventional doctor.

Instead, they will visit traditional doctors who sometimes end up worsening their injuries. The national team has an able doctor who could have properly managed your problem which may have lingered on because of lack of proper treatment or taking painkillers and continuing to play without proper healing.

The pain killers, apart from worsening injuries are likely to cause other problems including bleeding from acquired stomach ulcers or perforation which, if not attended to quickly can be fatal. Pain in the muscle acts as a warning sign of an injury, which requires seeing a qualified medical worker instead of controlling the pain using painkillers.

Ugandan footballers also believe in anti-pain sprays a lot which anybody including fellow footballers can rush on the pitch with and spray the injury. And regardless of whether the muscle is injured or not even without assessing the type or extent of injury, they usually opt for massage, which further damages the muscle. Massaging an injured muscle (except if one has a muscle pull) is like pressing an open wound hoping it will heal but instead it gets worse.

The most important treatment for non-open muscle injuries including knocks is ice and rest (RICE).The doctor who will continuously assess the injury will advise how to apply ice and how long the rest should be. In some circumstances, a doctor may recommend physiotherapy which may include ultrasound physiotherapy. Many people erroneously call physiotherapists masseurs and think their only treatment is by merely having a massaging. Please visit Dr Ronal Kisolo, the national team doctor for further help.

Dear doctor, since 2004, I have noticed whenever I am about to start my periods, I get nosebleed. At first I thought the problem was due to an allergy but it is becoming more regular and this worries me. After consultations, I was told to just hold my nose whenever it happens. Could this be a sign of blood cancer?
Mellisa

Dear Mellisa, nasal bleeding is commonly associated with breathing in dry air, nasal allergies, a common cold or a sinus inflammation, the reason why you think it could be the allergies causing your bleeding.

This nasal bleeding usually takes place in the frontal areas inside the nose, and coming from arteries the blood is mostly bright red. Though it is true that one may have allergy-like symptoms in the nose with nasal running or stuffiness (non-allergy rhinitis) related to hormonal changes of periods risking nasal bleeding, it is unlikely that one will bleed from the nose regularly with periods as a result.

It could be that you are experiencing what is known as vicarious menstruation. This happens when some membranes, apart from that inside of the womb bleed at the time of menstruation.

Though bleeding in the nose is the most common type of vicarious menstruation, other areas including tear glands may also bleed as a result of hormonal changes that lead to menstruation.
The hormonal changes affecting the nose may lead to the blood vessels over-filling, and breaking-up leading to nosebleeds. In this case, the blood is dark compared to the usual nasal bleeding.

The first aid of nose bleeding is to firmly hold the nose with the thumb and middle finger for about 10 minutes while one breathes so that clot formation blocks the bleeding. Blood cancer may also show up with recurrent nasal bleeding but not regularly at the time of menstruation. Though vicarious menstruation is rare and usually harmless, you should check with your doctor to rule out other causes of abnormal bleeding.

Dear doctor, I am worried about the weight I have gained after giving birth. When I was pregnant, I did not put on a lot of weight. What could the problem be?
Fattie Abwooli

Dear Fattie, women normally gain 12 to 15 kilogrammes on average during pregnancy and most will gradually return to their pre-pregnancy weight after they have delivered. Optimum weight during pregnancy is good for the mother and the healthy growth of the baby.

Some mothers may remain big or even gain weight after delivery due to overeating and failing to exercise when breastfeeding. Ugandan women claim that for proper milk production, they require consuming lots of porridge (especially finger millet) with milk, and sleep a lot during the day claiming they have to tend to the baby at night hence ending up obese.
A breastfeeding woman needs to have a balanced diet with a lot of fluids and avoid stress for proper breastfeeding. She also needs to exercise to keep physically fit. You should visit your doctor who will advise you on the kind of diet and exercises to perform to gradually reduce your weight. Abrupt loss of weight while you are breastfeeding is not possible, or even if it was, it is unhealthy.

Dear doctor, my hands shake whenever I am about to sit for exams, and writing becomes a problem. I have even visited a herbalist because I was told it is an African disease which requires an African solution but this has not helped. Please advise.
Catherine Zzirintusa

Dear Catherine, tremours are unintentional, uncontrollable rhythmic muscle movement which can affect any part of the body. In Uganda, they are traditionally thought to result from having committed adultery with a father or mother in-law requiring traditional rituals to get cured.

Tremours are generally caused by problems in parts of the brain that control muscles throughout the body but happening mostly in the hands, the part of the brain that controls the hands. Sometimes, tremours may be a side effect of drugs. The most common form of tremours, however, occurs in otherwise healthy people, is harmless, but can be embarrassing apart from making it harder to perform an ordinary task like in your case writing exams. This tremour is most noticeable when a person is engaged in an activity such as lifting a cup or writing and mostly runs in families.

Although the shaking can occur at any age, it is most common in people older than 40 years, and may worsen over time to affect the head, voice, arms or legs. It may be aggravated by emotional stress, fatigue, caffeine or extremes of temperature. It is likely that stress associated with exams could be the trigger of your problem and unfortunately making it difficult for you to write your exams.

Some people with mild symptoms may not require treatment, but simply avoid the said aggravating factors. Visit your doctor to treat you to reduce or relieve the tremours. You should also deal with the conditions that trigger or worsen tremours including avoiding caffeine. Caffeine is found in coffee, though less in tea, and some carbonated drinks.

Please take alcohol sparingly or not at all because although it improves tremours, it is not a good solution since apart from being addictive, tremours tend to worsen once the effects of alcohol wear off. Being relaxed may improve tremours by reducing anxiety and stress.

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