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Dr Gareth Smith; I want my toe to be shortened.

Byline: Dr Gareth Smith

Q I WATCHED a TV documentary recently showing cosmetic operations in America for height and toe reduction. I would love to have my second toe shortened, as it is embarrassing when I wear sandals. Is this available on the NHS?

A SORRY, cosmetic operations like this are not available on the NHS and there are few surgeons in the UK who specialise in cosmetically shortening bones. If your long toe is causing you problems, such as calluses or bunions, then a referral to a podiatrist would be indicated. Toe shortening for cosmetic reasons can have complications and is something that should be considered very seriously. If you do wish to proceed with it you may have to travel as far as London to have it done privately, but I would not recommend this treatment unless it is necessary for your health.

Q JUST over three weeks ago I banged my head on a kitchen door. I had an X-ray at casualty and they said everything was all right. A few days later I banged my head again and it was much more painful. Since then my tinnitis has got much worse and I have headaches. What could it be?

A TINNITUS is a ringing in the ears usually caused by nerve damage in the inner ear. I suggest you ask your doctor to arrange a CT scan of your head, especially if your tinnitus is accompanied by headaches which are worse in the morning. Sometimes head injuries can present with late-developing symptoms, so please make an appointment with your doctor as soon as possible.

Q I HAVE a kidney stone, which is causing me excruciating pain from time to time on my right hand side. Doctors at the hospital told me I might pass the stone but if I didn't they would treat it. What does this involve?

A SUFFERERS often say kidney stones cause the worst pain possible. They are caused by a build-up of calcium in the kidney that can get stuck in the ureters, which are the tiny tubes which take urine from the kidney to the bladder. If the stone is small enough it will pass through the ureter and eventually come out, almost like gravel in your urine. There is a treatment where the stones get blasted with ultra-sonic waves, which smash them up into smaller pieces. You then pass them normally in urine. If you still have pain I suggest you push for this with your doctor.

Q MY three-year-old grandson's baby teeth came in black and had to be removed. Can you tell me why this was?

A CERTAIN antibiotics taken by the mother during pregnancy, or by the child in early infancy, can cause teeth to be weakened and stained. If this was the case, your daughter should ask her doctor why they were prescribed, as these antibiotics should be avoided in pregnant women and babies. It could be your grandson simply had tooth decay. Or he may have been born without enamel on his teeth, but this usually affects the second teeth. Ask your daughter to discuss the causes with her son's dentist.

Q I SUFFER from nerves and stress and have gained two stones in weight. My doctor says this is caused by my metabolism not working properly. What did she mean by this?

A YOUR doctor may be talking about your thyroid gland. In some cases an over or under-active thyroid can cause anxiety and depression. The thyroid produces hormones that set your metabolic rate and directly affect your energy levels. Ask your doctor to be a bit more specific, as if this is the case your thyroid will need to be treated. Otherwise, your anxiety is better treated with an antidepressant.

Q MY wife has suggested I go for a vasectomy. But I am extremely worried it will affect my sex life.

A A VASECTOMY is a very simple operation, usually done under local anaesthetic. It involves a small incision in the top of your scrotum. The spermatic cord is then cut and shortened. The most painful thing is the local anaesthetic injection, but you may be tender for some days afterwards. It does not affect your sex life after the wound is healed, as most semen comes from the prostate gland and seminal vesicles. Sperm is a very tiny proportion of it. It is the safest method of long-term contraception. But it can take months for you to have a negative sperm count so you must use other contraception until you get the all-clear.

Q AN MRI scan showed I have a tear my knee cartilage. The consultant told me there is a year waiting list for an operation. But sometimes I am in such agony I can't walk. How much would it cost to have the op done privately?

A IT does seem ridiculous you have to wait so long. Ask your doctor to refer you to a physiotherapist. Simple exercises and ultrasound may help reduce swelling, and strengthen the muscles around the knee. I can't say how much it will cost to get it done privately, but you could ask your GP to recommend a surgeon and ask how much he charges. Or, you could ask to see your consultant again, explaining that your situation has got worse and is now unbearable. This may speed you up the waiting list.

IF you have a medical query, write to Dr Smith, Seven Days, Sunday Mail, One Central Quay, Glasgow G3 8DA or e-mail me at Your letters cannot be answered personally.
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Title Annotation:Health
Publication:Sunday Mail (Glasgow, Scotland)
Date:Jul 28, 2002
Previous Article:Healthcheck:; Three to four years.
Next Article:Complementary medicine.

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