ASK THE DOC

Spe­cial­ist sur­geon and lec­turer Dr Sarah Rayne an­swers your ques­tions

Fairlady - - CONTENTS - BY DR SARAH RAYNE Send your ques­tions to let­ters@fairlady.com

Q: What’s the dif­fer­ence be­tween pro­bi­otics and pre­bi­otics?

A: Un­der­stand­ing how to im­prove our diet is be­com­ing more im­por­tant as food be­comes more pro­cessed. ‘Pro­bi­otics’ re­fer to pro­bi­otic bac­te­ria – ‘good’ bac­te­ria such as lac­to­bacil­lus that mul­ti­ply in the gut and en­sure that harm­ful bac­te­ria don’t cause dis­eases. Good bac­te­ria form part of your in­testi­nal mu­cosal de­fence sys­tem (the re­la­tion­ship be­tween your gut and th­ese bac­te­ria pro­motes good health by staving off di­ar­rhoea, in­flam­ma­tion and other in­fec­tions) and may have cancer-killing prop­er­ties. Th­ese ef­fects are be­ing stud­ied, but most doc­tors agree that th­ese bac­te­ria are a good way to sup­port a healthy gut.

To main­tain a healthy num­ber of pro­bi­otic bac­te­ria, you have to feed them what they like to eat – ‘pre­bi­otics’. Th­ese are non-di­gestible car­bo­hy­drates (fi­bre and roughage) that the bac­te­ria need to sur­vive. Foods rich in pre­bi­otics in­clude ba­nanas, oat­meal and grains, as well as green beans.

Eat ‘func­tional’ foods – any­thing that con­tains a pro­bi­otic or pre­bi­otic – as they have a health ben­e­fit be­yond their nu­tri­tional in­gre­di­ents. ‘Live’ yo­ghurt has a mix of pro­bi­otic bac­te­ria, pre­bi­otics and other nu­tri­ents. Eat­ing prod­ucts for­ti­fied with pro­bi­otics won’t treat in­fec­tions but may help keep your gut reg­u­lar and healthy.

Q: I’ve been breast­feed­ing for six months and my hair has been thin­ning no­tice­ably. Should I wean my baby off the breast?

A: Hair loss af­ter preg­nancy is a fas­ci­nat­ing but nor­mal event. While women try to be as well pre­pared as pos­si­ble for the ac­tual birth, they’re of­ten un­pre­pared for the changes to their bod­ies.

Breast swelling as a re­sult of breast­feed­ing is ex­pected – but did you ex­pect your sex drive to change, your feet to get big­ger (and per­haps stay big­ger) and your hair to fall out? In fact, you haven’t lost any hair: dur­ing preg­nancy, the changes in your hor­mones dis­rupt the nor­mal cy­cle of hair loss and you stop shed­ding hair. That’s why your hair looks so thick and glossy when you’re preg­nant. When you give birth and your hor­mones re­turn to nor­mal, you sud­denly start shed­ding all that ex­tra hair. You’ll no­tice the re­growth as shorter pieces of hair for the next year or so.

Women who don’t breast­feed ex­pe­ri­ence the same thing, so you don’t need to wean your baby. Well done for get­ting this far! The good news is that the big­gest changes in your hair oc­cur in the first three to six months, so it’s un­likely you’ll lose any more.

Q: Why are my feet sore ev­ery morn­ing? The pain passes af­ter a while.

A: It sounds like you may be de­vel­op­ing plan­tar fasci­itis (fash-ee-eye-tis), which is painful in­flam­ma­tion of the sole of the foot caused by overuse and stress. The bones of the foot link to­gether in an arch, and are held there by a tough fi­brous band (plan­tar fas­cia) that at­taches from the heel bone to the base of your toes. Planter fasci­itis of­ten starts with a feel­ing that you’ve bruised your heel, be­fore de­vel­op­ing into a pain in the sole of the foot in­side the arch. Most com­monly, as you men­tion, it’s worse in the morn­ing or af­ter sit­ting for a while.

Be­cause the in­flam­ma­tion is short­en­ing the plan­tar fas­cia, stretch­ing it again and re­duc­ing the in­flam­ma­tion are the best treat­ment. You can take non-steroidal anti-in­flam­ma­to­ries such as ibupro­fen to help with the in­flam­ma­tion. (But if you have kid­ney or stom­ach prob­lems, check with your doc­tor first).

At the same time, start do­ing a few ex­er­cises to help with the stretch. A phys­io­ther­a­pist can ad­vise you, and there are good re­sources on­line such as the Amer­i­can Or­thopaedic Foot & An­kle So­ci­ety (www.ao­fas.org). Keep­ing weight off the foot when it’s re­ally sore will also help, as will ice packs.

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