ASK THE DOCTOR
Readers’ queries have been answered by doctors of Down Town Hospital, Guwahati.
You can send health-related questions to [email protected]
Solutions to some of your health-related dilemmas.
My eight-year-old son wets the bed at night. What seems to be the problem?
– R. Das
Ans: Bed-wetting is quite common among children. It is just a stage in their development. It is also more common among boys than girls. Most children outgrow bed-wetting on their own over time. However, you could definitely begin by limiting the intake of fluids (water/milk/juice) before bedtime. Also, make sure your son goes to the bathroom at the beginning of the bedtime routine and again once just before going to sleep. Further, ensure that he stays hydrated during the daytime, thus limiting fluids in the evening hours. Please do not put too much pressure on him, as this may aggravate the bed-wetting for him.
Psychological Counsellor – Department of Psychiatry and Psychological Counselling.
I am in my 33rd week of pregnancy. I am 36. This is my second pregnancy. I have been diagnosed with gestational diabetes and consequently, I have drastically reduced my carbohydrate intake. As a result, I am almost back to my pre-pregnancy weight. My BMI is above 30. Will it affect the baby’s growth in any way?
Ans: In mothers with GDM, pregestational BMI≥ 25 kg/m2 and excessive gestational weight gain were significantly associated with increased infant birth weight. Weight management through nutritional prevention strategies could be successful in reducing the risk of GDM.
Normalisation of glucose levels during pregnancy is agreed to be the main factor in preventing poor outcomes in pregnancy. Dietary advice throughout pregnancy includes frequent small meals which contain carbohydrates that are not highly processed, rich with slowly absorbed starches and non-soluble polysaccharides, and with a low glycaemic index. The recommended daily calorie intake is individually suited to every woman. The main goals of nutritional management are to maintain balanced glucose levels and to provide enough energy and nutrients to all pregnant women, while minimising the risk of hypoglycemia (in women treated with insulin).
Managing your weight when you have gestational diabetes is not about dieting or trying to lose weight. However, to prevent the congenital anomalies, normal glucose level must begin in the preconceptual period and continue throughout pregnancy.
Managing your weight and controlling your blood sugar is about making small changes to your diet and levels of exercise to keep yourself and your baby healthy. If you are cutting back on sugary foods, you may find that you lose some weight or stay the same weight, instead of putting on weight. So long as it does not happen by cutting out nutritious food groups, this is safe.
If your pre-pregnancy weight is obese or BMI is more than 30, then weight gain during pregnancy should be about 4.5 to nine kgs.
Dr. Subhendu Malla Buzarbaruah,
Consultant – Department of Obstetrics & Gynaecology.
I am 17 years old and I was diagnosed with fibromyalgia last September (2020). I took prescribed medicines for the stipulated time and then stopped, as advised. I am continuing with physiotherapy. There was some pain relief in the last few months. Now the pain has started again. Please guide me on how to proceed further.
– S. Singh
Ans: Fibromyalgia is a chronic pain disorder, the cause of which is still not known. The treatment is mainly medical management, lifestyle management and behavioural therapy. The medications given by a rheumatologist should not be stopped without consulting him or her. The treatment is almost lifelong. In this disease, relapse and remission are inevitable. Better to control the disease process with minimum medications, along with other measures, as said earlier.
Dr. Pranab Kumar Chowdhury,
Consultant – Department of Rheumatology.
I will be 40 years old this May. My periods are still regular, but the flow and duration of periods have reduced. Is this normal at this age? When does perimenopause start for women?
– Shireen R.
Ans: Perimenopause starts at around 40 years, though it varies from woman to woman. If problem persists, you should consult a gynaecologist. All women of this age should do a few gynaecological examinations, namely, pelvic ultrasonography, Pap smear, blood for lipid profile and breast examination.
Dr. Nilakshi Phukan Kumar,
Senior Consultant – Department of Obstetrics & Gynaecology.