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Questions and answers p. 2

Hello! I am 35 years old and I am pregnant with my second child. Now it is the 12 week. I am disturbed by frequent headaches and they are severe enough. Yesterday I woke up with headache, it hurt all day and all night very badly. My blood pressure often rises, and during the examination I was told that it was after the stress suffered, although there was no stress. Any medicine other than glycine is forbidden, but it does not help. Tell me which examinations to take or how you can relieve headaches, situated as I am?
Answer: 06.07.2021

Headaches can be a manifestation of many diseases or a complication of the physiological course of pregnancy. In order to stop a headache, you need to identify the cause (you may have had vascular diseases before pregnancy). Given the early pregnancy, many drugs can be toxic to you. Therefore, it is necessary to consult a neurologist who will select individual program of examination and treatment for you.

Gaponova Irina Vasilievna
General practitioner. The highest category.
Hello! For about 2-3 years I have been suffering from shortness of breath. I am twenty years old, it appears both in the afternoon and in the evening. I visited many doctors - they have not found anything, the tests were also normal. The only thing was that they referred me for cardiogram, it showed clearly that I used to smoke, and the doctor referred me for ultrasonography of heart, but I didn’t go. I also suspect I have osteochondrosis. I read that shortness of breath can be due to osteochondrosis. How do I figure out why I have shortness of breath, and how can I treat it?
Answer: 06.07.2021

Shortness of breath can be associated with various diseases of cardiovascular system, respiratory system, thyroid pathology, pathology of the pharynx. It can also bother if a person has osteochondrosis of thoracic spine, nervous system diseases. In order to cure shortness of breath, you need to determine its cause. And only a therapist or neurologist can help with this. A comprehensive examination is needed, which will give an understanding of the underlying cause and a correct treatment plan. It is also worth undergoing ultrasonography of heart in order to exclude pathologies in this sphere.

Gaponova Irina Vasilievna
General practitioner. The highest category.
Hello! I quitted drinking alcohol for a couple of weeks. I have been drinking for about four years. After quitting, stabbing pain in heart started to appear even without exertion. What tests, procedures do I need to undergo to find out the cause of the pain?
Answer: 06.07.2021

Stabbing pain in the region of the heart can be a symptom of both diseases of the cardiovascular system and spine osteochondrosis (thoracic region), metabolic disorders with prolonged intake of alcohol, diseases of the respiratory system, thyroid gland, esophagus, disorders of the nervous regulation of the heart. In this regard, it is better to make appointment with a therapist who will select the required scope of laboratory and instrumental tests, as well as refer to comprehensive examination. 

Gaponova Irina Vasilievna
General practitioner. The highest category.
Hello. After covid, my blood sugar has been around 10 for more than a month. The diet did not help to a decrease sugar. I really would not like to take pills all the time. Can I expect that dietary sugar will start to decrease after all? What next steps would you recommend me to take?
Answer: 05.07.2021

Hello. In the postcovid period, an increase in blood sugar up to 12 mmol/l is possible, especially if hormones were used in the treatment, followed by the expected decrease to normal. It is recommended to follow a diet with blood sugar control before meals and 2 hours after. But it is advisable to consult with endocrinologist, undergo follow-up examination (tests, ultrasonography), so as not to miss severe endocrine disorders and the development of their complications, since Covid affects the entire endocrine profile.

Krasovskaya Irina Grigorievna
Endocrinologist. The first category.
Hello, over the course of several years my weight has decreased from 75 to 55 kg. Also I am bothered with about weakness, constant fatigue, frequent urination, itching of genitals, please tell me, can it be diabetes? Thank you!
Answer: 05.07.2021

Hello. The symptoms are very similar to those of diabetes. But to confirm the diagnosis, it is necessary to consult with endocrinologist, undergo follow-up examination, blood and urine tests for sugar, glycosylated hemoglobin. It is advisable to check the level of some hormones, as diabetes, like other metabolic disorders, can be the result of hormonal imbalance.

Krasovskaya Irina Grigorievna
Endocrinologist. The first category.
Hello! My daughter was diagnosed with adrenal hyperplasia five years ago at the age of 14.5 years. Since then, she has been taking hormonal contraceptives for treatment. Our current doctor refuses to cancel the drugs, saying that she will have to take it all her life. Please tell me if it is possible to refuse from taking drugs with this diagnosis? What negative health consequences this can entail?
Answer: 05.07.2021

Hello. The duration of hormone therapy and its need depends on how the disease began, the severity of the manifestations and the treatment goals (for example, the patient's desire to become pregnant). Additional examination is necessary: ultrasonography of pelvic organs on a certain day of the cycle and several adrenal hormones in dynamics. Transfer from oral contraceptives to other drugs or even their cancellation is not excluded. But this can be done only after patient intake and having all the necessary additional examinations, since abrupt withdrawal of oral contraceptives can lead to the bleeding development.

Krasovskaya Irina Grigorievna
Endocrinologist. The first category.
Hello! Please tell me, my husband has type 1 diabetes mellitus, acquired diabetes. We have two children, do we need any examinations for them in this case?
Answer: 05.07.2021

Hello. If children were born after the father was diagnosed with diabetes, the risk is about 3%. It is recommended to control blood glucose once every 6-12 months, during puberty - once every 3 months, consultation by endocrinologist. You can also take a blood test for antibodies to the pancreas insular apparatus.

Krasovskaya Irina Grigorievna
Endocrinologist. The first category.
Hello. I am twenty. Recently I underwent ultrasonography of thyroid gland and took blood for hormones, they told me that I have thyroid gland of 7-8 year old child. Please tell me what this means and what the consequences can be?
Answer: 05.07.2021

Hello. This may be a sign of other endocrine organ failure. For an accurate diagnosis, additional examination of pituitary and adrenal glands in terms of hormonal state is necessary. The consequences of insufficient thyroid gland can manifest itself in the form of a slowdown in metabolism, weight gain, deterioration of cognitive functions and increase in the risk of heart and vascular diseases. 

Krasovskaya Irina Grigorievna
Endocrinologist. The first category.
Hello. The child has been suffering from ARVI for a week. All symptoms (fever, nasal congestion) gradually subside, but coughing is very disturbing. It is especially aggravated at night - productive, the child cannot clear his throat for a long time. Can you please tell me if this is considered as deterioration? Maybe we should already start drinking antibiotics? Thank you
Answer: 28.05.2021

Hello! A child's nighttime cough is not considered a worsening or complication of the current illness. Most often in children, this is a sign of rhinosinusitis, postnasal drips, which can bother the child for a long time. Most likely, there are no reasons for prescribing antibiotic therapy, especially since the child has no fever or worsening of the general condition. For a more correct and accurate consultation, the child should be examined by a pediatrician, and in case of a prolonged nighttime cough, also by a pediatric otolaryngologist.

Hello. The child is 6 years old, a planned visit to all doctors is needed for a certificate to school. Can you please tell me if a pediatrician at your clinic can make such a certificate? And is it possible to see all the doctors in one day?
Answer: 28.05.2021

Hello! All pediatric specialists work at ON Clinic, the consultation of which is necessary for a child upon admission to educational institutions. The pediatrician, on the basis of advisory opinions, issues a form of primary accounting documentation No. 086, as well as a form No. 063 for registration in the school.

Hello. The child is 1.5 years old - there is not a single vaccination yet - we are sick all the time, we are plagued by ARVI. The district pediatrician puts a medical exemption. Can you please tell me if you can undergo a complete examination of the child and draw up an individual immunization schedule?
Answer: 28.05.2021

Hello! Frequent ARVI should not affect your child's vaccination, he/she needs vaccination, perhaps even more than children who are not sick. To clarify the child's immune status, general condition before vaccination, you need to carry out laboratory diagnostics, namely: clinical blood and urine tests, as well as immunogram, and after examination by a pediatrician, if there are no contraindications, draw up individual vaccination schedule. All this can be done in the ON Clinic pediatric department.

Hello. My daughter is 2 years old. Recently, we began to notice that she always keeps her mouth open - she did not breathe through her nose at all. A little wheezing in a dream, but not always. Otherwise, she is an ordinary, cheerful child. We were advised to see a doctor to rule out adenoids. Can you please tell me if we can undergo such examination at your clinic and what is needed for this?
Answer: 28.05.2021

Hello! Normally, the child’s nasal breathing should be free. If a problem arises with this, then the patency of the nasal passages should be restored, after finding out the cause. To do this, you need to contact the pediatric otolaryngologist of our medical center, who will carry out all the necessary diagnostic procedures to clarify the diagnosis.

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