Ask Dr. Rachna Pande

Dear Doctor, I find myself getting very anxious. What causes this and is it treatable?


Dear Doctor,
I find myself getting very anxious. What causes this and is it treatable?




Dear Glorine,


For how long have you experienced the problem? Did it start after some personal or family problem? Every individual experiences anxiety due to some stressful situations in life. It improves with improvement in the situation. But being anxious over trivial things or nothing is abnormal and a kind of neurosis. Symptoms of anxiety consist of dryness of the mouth, palpitations, breathing trouble, feeling of tightness in muscles, insomnia. One may have one or more of these symptoms. Chronic anxiety becomes stressful for a person and can lead to stress related disorders like hypertension, heart diseases and peptic ulcer. Hence it is bad not only for mental, but physical health as well. 

Anxiety is treatable but not by drugs alone. Drugs like tranquilisers and sedatives help in reducing it transiently but do not cure it. Try to assess the situation/situations causing anxiety. Can you do something about it or not at present. If there is a solution go for it. If solution is not possible currently, wait patiently for things taking a better turn. Relaxation is very useful in reducing stress related symptoms. Yoga and meditation help in overcoming mental stress and providing mental relaxation. Keeping busy with creative hobbies also keeps mind occupied, happy and away from undue worries.

It is also vital to keep the body healthy physically, because a strong mind resides in strong body and a weak person feels depressed and anxious readily.



Dear Doctor,
I am nursing a very severe flu. Does this have anything to do with the onset of the rainy season? How can I deal with it?


Dear Angel,

Severe flu is often caused by viral infections. These spread as droplet infection. An infected person expels the droplets into the atmosphere while coughing, sneezing or talking. A person in the vicinity may inhale these drops and become sick. Contaminated hands or using contaminated handkerchiefs are yet other sources of infections. 

Viral infections and allergy are major causes of flu. / Internet photo.

Severity of infection depends on the load of viruses inhaled and the immunity of affected persons.

Flu causes one to suffer from a running nose, redness and watering of eyes, headache, body ache, dry cough, one or more of these symptoms. Mild fever may occur. High fever may be present if there is any superadded bacterial infection or flu occurs due to bacterial infection. Some people suffer from recurrent cold due to allergy with change of season or exposure to dust or pollens, potential allergy producing substances.

As such there is no definite treatment for flu. Symptoms can subside within a week without any active treatment. Drinking a lot of fluids, particularly warm water, is useful. Orange juice helps because it contains vitamin C which helps fight infections. Alcohol and excess caffeinated drinks should be avoided as they can cause dehydration.

Steam inhalation is beneficial in providing relief. If there is severe body ache, pain killer tablets are useful for a short duration.

Prevention consists of improving resistance of the body. Consuming zinc-rich food helps in enhancing resistance of the body. Pumpkin, squash, spinach, chick peas, lamb meat or whole wheat, are zinc-rich foods. Vitamin C is yet another substance which improves body’s ability to fight infections. Regular physical exercise also helps in keeping body healthy. Good hand hygiene goes a long way in avoiding spread of infections and minimizing the severity. Rooms in houses or work should be well aerated with adequate sunlight coming in. Those suffering from flu should be careful to cover their nose/mouth while sneezing or coughing. Use of disposable tissues to wipe the nose is a better choice than handkerchiefs which get contaminated due to reuse.



Dear Doctor,
For four months now, I always experience chest pain whenever I try to lift anything however small it is. What causes this and how can I overcome it?


Dear Julius,

You have not specified your age and the type of pain felt. Does the pain occur on lifting something heavy or any object? 

Tight constricting chest pain occurring after lifting heavy objects can be due to angina, a mild form of ischemic heart disease. Due to blocks in the vessels supplying blood to the heart, while doing heavy work, the heart is not able to pump the extra blood required, hence the pressure like pain. 

The pain may radiate to the arm, jaw and even upper back on left side. It lasts for few minutes and subsides spontaneously as the person abandons the heavy object being lifted and rests for a moment. 

Advancing age, obesity, lack of exercise, smoking, alcohol, stress, hypertension and diabetes, are some of the risk factors which make one vulnerable to ischemic heart disease. Along with pain, there may be sweating, palpitations, nausea, dizziness any one or more of these symptoms. This can be diagnosed easily by tests like electrocardiogram, cardiac echo and response to anti angina drugs. 

A young adult may get muscular pain while lifting a heavy object. Sometimes if the weight is very heavy it can cause a tear of muscle fibers causing severe, excruciating pain. Any previous fracture of rib or chest injury can be aggravated by lifting heavy weight causing much pain. One may have pain in the upper part of breast bone which is painful on touching. This occurs due to anxiety. 

Anxiety/stress can also cause muscular pains which may be severe depending on the underlying cause for stress and mental make up of a person. Any muscle rupture or pull can be detected by scans like C.T. and MRI. Treatment rests in giving rest to the part by splinting it and pain killer drugs.

Avoid lifting heavy objects for some days. Avoid bending as well. Try to sit straight on your knees and lift something from the ground. If pain continues, it is advisable to do suitable investigations to detect any underlying pathological cause.



Dear Doctor,
I am on family planning but I have not had my periods for six months now. Should I get worried?


Dear Anitha,

It seems you have what is called post pill amenorrhoea, i.e. lack of menstruation after stopping a hormonal contraceptive. The menstrual and fertility cycle of a woman is controlled by balance of the hormones estrogen and progesterone.

Periods occur when after ovulation, the ovum is not fertilized and embedded in the uterus. At this time the level of estrogen falls and progesterone surges. The cycle of ovulation and menstruation is determined by hormones (follicle stimulating and leutinising) produced by the pituitary gland. Hormonal contraceptives taken in any form, i.e. tablet or injection tend to suppress the endogenous production of these hormones, thus suppressing ovulation and preventing contraception. 

Usually after stopping these contraceptives, one may have lack of menstruation for 3 to 6 months and it should recover after that spontaneously. If not, a drug like clomiphene citrate is used to reset the hormonal balance. 

If a woman has been on oral pills and failed to take it some day, there is risk of pregnancy as well, causing absence of menses. During early pregnancy, one may not have the typical features of pregnancy. Pituitary and thyroid disorders can also cause amenorrhoea. It can also be due to conditions like polycystic ovarian syndrome. Obesity, extensive physical training as for athletes, are other causes of disruption in menstrual cycle and amenorrhoea. 

Drugs used for treating cancer or schizophrenia, can cause amenorrhoea as adverse effect. 

I think you should not worry at present, expect menstruation to begin any time now. If not, it would be good to get investigations done to exclude some underlying pathology for amenorrhoea, which can be treated in time.

Keeping a healthy life style ensures that body’s hormonal status remains balanced.

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