Dr Jiana Harith Darwish is a paediatric allergy specialist and clinical immunology fellow at the King Faisal Specialist Hospital and Research Center. Each month she answers your health questions.
Q: A good friend and colleague recently suffered what has been explained as a minor stroke. She received almost immediate medical treatment and seems to be recovering well but says she finds trouble sleeping and becomes easily irritable. She will be returning to work soon and I’m wondering about what needs to be taken into account and how we can help her?
A: Sometimes called a mini stroke, a transient ischaemic attack (TIA) has analogous symptoms to a stroke but the person appears to recuperate swiftly. The medical definition for TIA is:
• Transient: Symptoms disappear in less than 24 hours;
• Ischaemic: Failure of blood flow to part of the brain or eye;
• Attack: Sudden onset of symptoms which vary from person to person depending on which part of the brain or eye is starved of blood.
TIA symptoms are determined by which blood vessel to the brain is blocked and accordingly which part of the brain is starved of blood. Common symptoms include brief attacks of weakness, clumsiness, numbness or pins and needles of the face, arm or leg on one side of the body, slurring of speech or difficulty in finding words or blurred vision in one or both eyes. TIAs do not usually cause ‘blackout’ fainting or loss of consciousness.
An individual who has had a TIA has an increased possibility of having a stroke. The risk of having a stroke in the first year after a TIA is about 10 per cent but then falls by about five per cent each year.
The treatment depends on the results of a vigilant assessment by the physician. Any person who smokes should stop completely. People with high blood pressure, high cholesterol or high sugar levels in the blood can typically be helped by a healthier diet, though drugs are sometimes needed. So your role is to encourage her to modify her lifestyle. A physician may also prescribe aspirin to thin the blood; this reduces the risk of having a stroke after a TIA. Sometimes TIAs are due to narrowing of a blood vessel in the neck; this can be treated surgically by a carotid endarectomy. Therefore, if anyone has an attack with symptoms similar to those described, it is essential that they should see a physician at once, so that, if needed, the earliest possible treatment can be initiated.
Q: I have recently lost a fair amount of weight. As I got heavier, over a number of years, I noticed that my shoe size increased. Is it reasonable to now expect my feet to go back to their previous size or will they always be somewhat splayed?
A: When we lose weight, we tend to focus on a flatter stomach, smaller hips and model cheekbones. Our feet may be the last thing on our mind when we are on a journey to weight loss, but they walk us through that path. We tend to forget shoes changed Cinderella’s life.
Your feet can be affected when you gain excessive weight. First, they will begin to grow, both as a result of the extra weight on your body and a restructuring of the bone structure inside them. In response to the extra weight, the bones inside your feet will begin to compress on top, and your foot will become flatter. This can assist you to retain your balance as you get heavier, but it can be complemented by its share of pain and joint problems.
Although your feet may feel a little less cramped in your shoes, it is vital to note that not everyone experiences shrinking feet during weight loss. For most people, weight loss in the feet typically happens after losing more than 10 kilograms. For some people, it may take losing more than 25 kilograms to see a difference.
If you have a question for Dr Jinan, please email firstname.lastname@example.org