Health: A Question of Health

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I am 33, and for six weeks I've had chest pain which the GP says is caused by costochondritis. The pains are on both sides of the breastbone and they are worse when I bend or twist. The ribs seem very tender. Is there any way to get rid of this?

Costochondritis is painful, but not serious, and nearly always gets better over the course of a few months. It is an inflammation of the small piece of cartilage that connects each rib to the breastbone. Every movement of the upper body, at times even breathing and coughing, causes this cartilage to move and is therefore painful. The tissues around the cartilage sometimes swell. Tietze's syndrome is another name for this condition. Treatment with anti-inflammatory painkillers, such as Ibuprofen, will helpthe pain and swelling. No one knows the underlying cause.

I am desperate to lose weight and after years of dieting and bingeing I realise I need to reduce my calorie intake permanently. What foods should I cut out?

Fat makes you fat, because every gram of fat contains roughly twice as many calories as an equivalent gram of protein or carbohydrate. One gram of fat contains 9 kilocalories, compared to a gram of carbohydrate or protein that only contains 4 kilocalories. Look at the nutritional information on food containers. Anything with more than about 15 per cent fat is going to be bad for you. Go for big portions of vegetables, which are virtually fat-free, and small portions of meat. Avoid fried food, which soak up fat in the cooking process. Butter and margarine are virtually 100 per cent fat, so learn to love bread and potatoes without them. A low-fat diet will also reduce your risk of heart disease and keep your cholesterol level down.

My son's hearing and speech have been badly affected by "glue ear". The specialist suggests an operation to insert grommets into his ears. Is there any natural way of removing "glue" from the ears without an operation?

"Glue" is the term that is used to describe a sticky fluid that collects behind the eardrum and blocks the passage of sound through the ear. It usually accumulates because the body's natural drainage system has failed. The normal drainage channel is the eustachian tube, which connects the ear to the back of the nose and throat. When this tube doesn't open and close normally, "glue" accumulates in the middle of the ear.

In my experience, "glue ear" often resolves itself spontaneously without the need for treatment. But if your son's hearing and speech are being affected, grommets offer a quick way of helping the ears to drain. A grommet looks like a tiny cotton reel. It is inserted in the eardrum allowing air to get behind it and so help the "glue" to disperse.

Please send your questions to: A Question of Health, The Independent, 1 Canada Square, Canary Wharf, London E14 5DL; fax 0171-293 2182; or e-mail them to health@independent.co.uk. Dr Kavalier regrets that he is unable to respond personally to questions

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