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Why is our son's gait lopsided? And how can I clear up excess ear wax?

Why is our son's gait lopsided? And how can I clear up excess ear wax?

ONE-SIDED DEBATE

Our 18-month-old boy has been walking since the age of 13 months. Recently we have noticed that he seems to be favouring one side of his body over the other. He uses his right hand more than his left, and his walking is very slightly lopsided. He is doing everything that he should be doing for his age, and when we mentioned our concern to the health visitor she was dismissive. Is this just part of normal development? Does it simply mean that he is right-handed? Or could there be some other cause that needs looking into?

When babies are born it is not at all obvious if they are going to be right or left-handed. If a newborn uses one hand more than the other, it is often a sign that something is amiss with one limb or on one side of the body. As babies develop into toddlers, it begins to become clearer if they are going to be right or left-handed. Sometimes, it is not clear until a child is four, or even five. Some people never develop a preference and are truly ambidextrous - they use their left and right hands equally.

Lopsided walking is a sign that is always worth taking seriously. If may not mean anything, but it could be the first sign of something significant. Hip joints that are not properly in their sockets can cause lopsided walking. Weakness on one side of the body (hemiplegia) is another possibility that needs to be considered. I strongly recommend that you take your son back to the doctor for a thorough examination. If your GP is at all concerned, he will refer you to a paediatrician.

A RIGHT EARFUL

For four years I have had a hearing aid. Since I started wearing it, my ears have needed syringing every eight weeks. I have had some suggestions about how to keep my ears wax free, but is there is a solution to the problem? It seems to be related to the fact that wax cannot escape from my ears while the hearing aid is in place (16 hours a day).

Your ears are probably producing more wax than previously, because the ear canals are being gently irritated by the hearing aid. The wax, as you point out, can't escape because the exit route is blocked by the hearing aid for most of the time. Your best hope is to encourage the wax to be as liquid as possible, and hope that it drains out when you are not wearing the hearing aid. I would suggest using gentle sodium bicarbonate ear drops every night before you go to bed. In the morning, gently wipe away any visible wax with a tissue. Do not, under any circumstances, use cotton buds to clean your ears. They are notorious for making the problem worse by pushing wax deep into the ears.

OVERSIZED CELLS

I have just received the results of an anaemia blood test, which shows that I am not anaemic, but my red blood cells are bigger than they should be. I have now had another blood sample taken to try to discover the underlying cause. I am 32 years old, female, and very healthy, although recently I have been feeling rather worn out, which is why anaemia was suspected. I do not eat red meat, but my diet contains plenty of iron, vitamins and minerals. What is the significance of having red bloods cells that are too big? Will it lead to anything more serious? Could it account for my tiredness?

There are a few things that can make the red blood cells grow too large. If your body is deficient in folic acid or vitamin B12, it responds by producing extra-large red blood cells. If you have a good mixed diet, you are unlikely to be deficient in either of these nutrients. Another possibility is that you are not able to absorb vitamin B12. This occurs in a condition called pernicious anaemia. Your second blood sample will probably be used to check if you have enough folic acid and vitamin B12 in your system. But the commonest cause of enlarged red blood cells is excessive alcohol intake. If you drink more than two or three units of alcohol a day, this may be the reason behind the abnormal red blood cells. Your doctor will probably also look at your liver-function tests. Even if these are normal, you should reduce your alcohol intake to see if this brings the red blood cells back to their normal size. You should see an improvement within three months. Enlarged red blood cells in themselves should not cause any symptoms.

HAVE YOUR SAY: READERS WRITE

HC from Lancashire tells of her personal experience of undiagnosed vulval pain:

As a child I suffered from vulval soreness, but as a teenager and in my twenties I had no problems at all. When I was 34 I was diagnosed with thrush and given Canesten, despite the fact that swabs were always negative. Finally I ended up with permanent vulval pain and was diagnosed with dysaesthetic vulvodynia. It causes constant burning and soreness as a result of nerve fibres being irritated and damaged. These fibres then send abnormal signals back to the spinal cord, where they are experienced as pain. Women who have undiagnosed vulval-pain problems should contact the Vulval Pain Society, POS Box 514, Slough Berks SL1 2BP. It offers a handbook with information that may help. It also has a list of gynaecologists who are familiar with vulval-pain syndromes. Their website is www.vul-pain.dircon.co.uk.

Send questions and suggestions to A Question of Health, 'The Independent', Independent House, 191 Marsh Wall, London E14 9RS; fax 020-7005 2182; or e-mail health@independent.co.uk. Dr Kavalier regrets that he is unable to respond personally to questions

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