Why do doctors insist on knowing my family history?

Dr Flo,
Kindly define genetics.
Often doctors ask patients about their family history in relation to conditions like hypertension, diabetes among others, so that they can do a proper diagnosis and start on treatment.
What is the significance of this information? Also, what are generic drugs? Please shed light on this.
Alnashir D Walji

Dear Alnashir,
Genetics refers to the biological make up of an individual based on their genes. Genes are units of biological material found in our cells that “dictate” how our body develops and the different traits that we get. We get a set of genes from each of our parents, which means that traits are passed down from our parents to us such as hair colour, eye colour and blood type. Genes could also carry traits that cause disease or that make it easier for someone to get a particular disease for example hypertension, diabetes, sickle cell disease, some cancers and some psychiatric disorders. This means that there are some diseases we are at higher risk of developing if our parents or other close relatives also had them.
What are generic drugs? The active ingredient in a drug is known as the generic name of that drug. This is different from the brand name which is the name given to that drug by a specific company. For example, the active ingredient paracetamol (generic name) is present in different medications with different names made by different companies. Another use of the term generic is in reference to medication made to be similar to the original drug developed by a specific company. This generic medication is similar to the original, but is usually cheaper since the company that developed the original molecule had to bear the cost of developing the drug, taking it through research and drug trials and seek approval from the relevant authorities.

Dr Flo,
I am 27 years old. I experience pain below my chest, mostly the left side. This mostly happens when I am tired. Sometimes it happens when I walk for a while after just eating food. What could be causing this?
Martin

Dear Martin,
Since the left sided chest pain seems to come after walking for some time or when you are physically tired, then it is highly likely that it is due to a muscle strain. In between the ribs, there are three layers of muscles, known as the intercostal muscles and there are also many other muscles on the front and back of the chest extending to the abdomen and also along the spine. Any of these muscles could ache. This is called myalgia (muscle pain) and is either due to recurrent strain, repetitive activity or even from muscle cramps. When you physically exert yourself, you can also get dehydrated which can lead to muscle pain. This can be managed by rest, or painkillers and muscle relaxants.
Also, if you do something that causes you to use your muscles immediately after eating, for example going for a walk, the body can get confused. Immediately after eating, the body directs a lot of blood flow to the stomach and intestines to help with digestion. This is why most people usually feel lazy and sleepy after eating - because there is less blood going to the brain and muscles. If you exercise soon after eating, the body has to send more blood to the muscles, providing far less blood to the stomach and intestines, which can lead to an interruption or slowing down of digestion, and this can lead to discomfort and pain. This pain usually goes away on its own after some rest.

Dr Flo,
I think I have an infection because I get wounds on my private parts before or after my periods. I also get a discharge and I am itchy for a day before and several days after my periods. What could be the problem?
Reggie

Dear Reggie,
It is normal for all women after puberty to have a vaginal discharge. It is a mixture of fluid and cells that help to keep the vagina clean and moist and to prevent infection. The appearance changes depending on the menstrual cycle, and can also be affected by exercise, stress, use of hormonal medication and sexual arousal. The discharge may vary from white to clear, and from watery to thick, at different times of the cycle. It is also normal to have a brown or bloody discharge just before, during or after your periods, or sometimes in between your periods (spotting).
If there is abnormal colour (yellow, green, sometimes white), itching, a foul smell, or thick, chunky discharge, lesions, wounds or cuts, then most likely there is a vaginal infection. The infection may be caused by fungi, bacteria or other organisms. There is a higher risk of infection around your periods due to the hormonal changes, and also due to the wetness of the area and the use of pads. You may also be reacting to the female hygiene products you are using.
To know the actual cause of the wounds, you should visit a gynaecologist for examination when the wounds are present. The doctor may also ask for a urine test, a pap smear, and other tests. Once the diagnosis is established, you will be put on medication, and given advice on what to do in the future.
To avoid infections, keep the area clean, wipe from front to back when using the toilet, wear cotton underwear, avoid excessively tight underclothes like tights and bikers, avoid use of scented soaps and douches.

Send your medical questions to [email protected] for free expert advice