Body odour: it’s unpleasant

By Dr Hilary Jones

Body odour is never pleasant, and we’ve all been crammed on a train or been in a busy shopping centre and noticed the distinctive smell of stale sweat. Men sweat more than women, so it’s no surprise they are the worst offenders. But is it a case of poor hygiene or do some people have a medical condition that makes them sweat more than average?

Strange as it may seem, many people with bad body odour are unaware that they smell. Scientific research has shown that some people cannot detect certain molecules. Their nostrils may be able to register the smell of garlic or curry, but not the smell emanating from their armpits.

Everybody sweats. We have to. Perspiration is the body’s biological way of cooling down. Sweat itself does not smell, but it is a wonderful culture for the bacteria that live on our skin. The bacteria breaks down sweat into aromatic fatty acids, which produce the unpleasant odour.

This means body odour can be tackled by: *reducing the amount of sweat * treating the bacteria that produce the odour. Medical conditions such as thyroid disease and carcinoid syndrome can cause excessive sweating, as can the side-effects of some medicines, eg antidepressants.

Wash with soap daily, particularly your armpits, groin and feet where there are many sweat producing glands. Washing removes sweat and reduces the numbers of bacteria that act upon it.

Some people have more sweat and oil producing glands than others. If you sweat a lot, you may need to shower two or three times a day. The use of antiperspirants and deodorants should be routine. It’s worth trying a few because they have different active ingredients, and you’ll find some work better than others.

Deodorants work by masking the smell of sweat with fragrance, while antiperspirants reduce the amount of sweat your body produces. Roll-ons tend to be more effective for heavy sweating. Another useful trick is to shave your armpits.

Armpit hair provides a greater surface area for sweat to adhere to and gives the bacteria a fertile breeding ground. It is also essential to wash clothes thoroughly, particularly clothing that comes into contact with sweaty areas such as socks, underwear and shirts. Never wear yesterday’s clothes. However clean your body is, the clothes will retain the smell of yesterday’s sweat.

You can get an antibacterial and antiseptic solution called chlorhexidine 0.05% solution from pharmacies.

Applied daily, it significantly reduces the number of bacteria, although it has no effect on sweating itself. There are a couple of surgical options for severe sweating (hyperhidrosis) which can’t be controlled by over-the-counter products. One is to remove a triangular area of skin in the apex of the armpit under local anaesthetic. A small piece measuring 4cm by 1.5cm is cut out, destroying the most troublesome sweat glands.

A modern variation on this procedure is liposuction to suck out the sweat glands from the deeper layers of skin.

Keyhole surgery

Another type of surgery is called trans-thoracic sympathectomy. It’s done under general anaesthetic and uses keyhole surgery to destroy the nerves that control sweating. The surgeon makes an incision in your armpit and passes a fine needle under the second, third and fourth ribs on each side.

An electrical current then kills off the nerves. The success rate is about 40 per cent, but because the body still has to sweat, some people experience increased sweating from their chest, abdomen and back after the op. It’s important to understand this before undergoing surgery, because it cannot be reversed. Botox Botulinum toxin is a recent alternative to surgery.

Known as Botox, it’s more often used as a treatment for facial frown lines. Botox is only licensed as a treatment for excessive sweating from the armpit (axillary hyperhidrosis), so it can’t be used for sweaty hands and feet.

A small amount of the toxin is injected into multiple sites in the skin at the apex of the armpit. Although the results only last a few weeks, it’s an effective and safe treatment.

If you’re thinking about surgery, you could try Botox to see how effective an operation would be, and whether blocking sweat glands in your armpits causes excessive sweating elsewhere.

Pregnancy: a comfortable ‘journey’

The last few months of pregnancy can be physically and emotionally challenging. Your baby’s size and position may make it hard for you to get comfortable. You may be tired of pregnancy and anxious to get it over with. If you’ve been gearing up for your due date, you may be disappointed if it comes and goes uneventfully.

Try to remain positive as you look forward to the end of your pregnancy. Soon you’ll hold your baby in your arms! Here’s what to expect in the meantime.

Your body as your baby grows, his or her movements will become more obvious. These exciting sensations are often accompanied by increasing discomfort and other late pregnancy symptoms.

* Backaches. As your baby continues to gain weight, pregnancy hormones relax the joints between the bones in your pelvic area. These changes can be tough on your back. Hip pain is common, too. If you must stand, place one foot on a box or stool. Sit in chairs with good back support. Apply a heating pad or ice pack to the painful area. Ask your partner for a massage. If the back pain doesn’t go away or is accompanied by other signs and symptoms, contact your health care provider.

* Swelling. Swollen feet and ankles may become an issue at this stage of pregnancy. Your growing uterus puts pressure on the veins that return blood from your feet and legs. Fluid retention and dilated blood vessels may leave your face and eyelids puffy, especially in the morning. If you have persistent face or eyelid swelling, contact your health care provider.To reduce swelling, use cold compresses on the affected areas. Lying down or using a footrest may relieve ankle swelling. You might even elevate your feet and legs while you sleep. It may also help to swim or simply stand in a pool.

* Shortness of breath. You may get winded easily as your uterus expands beneath your diaphragm, the muscle just below your lungs. This may improve when the baby settles deeper into your pelvis before delivery. In the meantime, practice good posture and sleep on your side.

As long as your health care provider says it’s OK, aerobic exercise can help relieve this pregnancy symptom, too.

* Heartburn. Your growing uterus may push your stomach out of its normal position, which can contribute to heartburn. To keep stomach acid where it belongs, eat small meals and drink plenty of fluids. If this doesn’t help, ask your health care provider about antacids.

* Spider veins, varicose veins and hemorrhoids. Increased blood circulation may cause small reddish spots that sprout tiny blood vessels on your face, neck, upper chest or arms, especially if you have fair skin. Varicose veins - blue or reddish lines beneath the surface of the skin - also may appear, particularly in the legs. Hemorrhoids - varicose veins in your rectum - are another possibility. If you have painful varicose veins, elevate your legs and wear support stockings. To prevent hemorrhoids, avoid constipation. Include plenty of fiber in your diet and drink lots of fluids.

* Stretch marks. You may notice pink, red or purple streaks along your abdomen, breasts, upper arms, buttocks or thighs. Your stretching skin may also be itchy. Moisturizers can help. Although stretch marks can’t be prevented, eventually they fade in intensity.

* Continued breast growth. By now, you may have an additional 1 to 3 pounds of breast tissue. As delivery approaches, your nipples may start leaking colostrum - the yellowish fluid that will nourish your baby during the first few days of life.

* Frequent urination. As your baby moves deeper into your pelvis, you’ll feel more pressure on your bladder. You may find yourself urinating more often, even during the night. This extra pressure may also cause you to leak urine - especially when you laugh, cough or sneeze. Continue to watch for signs of a urinary tract infection, such as urinating even more than usual, burning during urination, fever, abdominal pain or backache. Left untreated, a urinary tract infection may damage your kidneys and trigger preterm labor.

* Braxton Hicks contractions. These contractions are warm-ups for the real thing. They’re painless and come and go unpredictably. True labor contractions get longer, stronger and closer together. If you’re having contractions that concern you, contact your health care provider.

* Weight gain. By your due date, you may weigh 25 to 35 pounds more than you did before pregnancy. Your baby accounts for some of the weight gain, but you also need to count the placenta, amniotic fluid, larger breasts and uterus, extra fat stores, and increased blood and fluid volume.

* Vaginal discharge. Potentially heavy vaginal discharge is common at the end of pregnancy. If you saturate a panty liner within a few hours or wonder if the discharge is leaking amniotic fluid, contact your health care provider.

Your emotions as anticipation grows, fears about childbirth may become more persistent. How much will it hurt? How long will it last? How will I cope? If you haven’t done so already, you may want to take childbirth classes. You’ll learn what to expect - and meet other moms-to-be who share your excitement and concerns. Talk with women who’ve had positive birth experiences, and ask your health care provider what options you may have for pain relief. Tell yourself that you’ll simply do the best you can. There’s no right or wrong way to have a baby.

MayoClinic.com

Chronic neck pain

What is chronic pain? Pain that lasts for 3 months or longer is called chronic. Pain is your body’s way of telling you that something is wrong. It’s normal for you to have pain when you are injured or ill. But pain that lasts for weeks, months, or years is not normal.

Chronic pain can occur anywhere in your body. It can range from being mild and annoying to being so bad that it gets in the way of your daily activities.

Anyone can get chronic pain. It’s more common in older adults, but it’s not a normal part of aging. Older adults are more likely to have long-term medical problems, such as diabetes or arthritis, which can lead to ongoing pain.

What causes chronic pain?

The cause of chronic pain is not always clear. It may occur because brain chemicals that usually stop pain after you get better from an illness or injury are not working right. Or damaged nerves can cause the pain. Chronic pain can also occur without a known cause.

What are the symptoms?

Common symptoms of chronic pain include: * Mild to very bad pain that does not go away as expected. * Pain that is shooting, burning, aching, or electrical. *Soreness, tightness, or stiffness. What other problems can chronic pain cause? If you have pain for a long time, it can make you feel very tired and may lead to depression. It can get in the way of your usual social and physical activities. You may have so much pain that you can’t go to work or school. The emotional upset may make your pain worse. Your body’s defense system (immune system) may get weak, leading to lots of infections and illnesses.

How is chronic pain diagnosed? Your doctor can find out if you have chronic pain by asking about your past illnesses and your overall health. He or she will also do a physical exam. You may have tests to find out if a medical problem is causing the pain. Your doctor may check for problems with your nervous system and may order blood tests. He or she may also ask you questions to check your mood and mental health and to see how well you are able to think, reason, and remember.

In most cases, test results are normal. This can make it hard to know the exact cause of the pain. But this doesn’t mean that your pain isn’t real. How is it treated? You can use home treatment for mild pain or pain that you have now and then.

Exercising, getting enough sleep, and eating healthy foods may help reduce chronic pain. Using over-the-counter pain medicines such as acetaminophen, aspirin, or ibuprofen may also help. You may want to try complementary therapies such as massage and yoga.

Talk to your doctor if your pain does not go away or if it gets worse.