Q. I take the oral contraceptive pill, but I am prone to miss pills. So far I have been lucky and not got pregnant. What is the best thing to do if I miss a pill?
A. The most risky time for missing pills is at the beginning and end of the packet. If you miss your pill in the morning, but remember to take it at night, you will be fine. If you completely miss a pill for 24 hours, you should keep taking the pill normally as soon as you remember. But missing a pill for more than 24 hours means that you may not be fully protected, and you should use additional contraception, such as a condom, for seven days. If these seven days run beyond the end of the packet, you should start the next packet immediately, without having a break. If you miss more than two pills, you should use emergency contraception, which is a single pill that can be bought at the chemist without a prescription.
WHAT EFFECT WILL STEROIDS HAVE?
Q. I have been diagnosed with polymyalgia rheumatica. The symptoms have been developing for months - lots of muscle aches and pain and stiffness in my shoulders. Since starting treatment (with steroid tablets) I have improved dramatically. I may have to take them for up to two years. What are the risks of taking steroids for so long?
A. Polymyalgia rheumatica affects women much more than men. It causes vague symptoms at first, such as muscle aches, but as it progresses it can become quite disabling. As you discovered, the response to treatment with steroids is dramatic. The problem is that if you stop taking the steroids too quickly, the symptoms come back. You may put on some weight because of the steroids. Long-term steroids will also affect the strength of your bones, so you need to discuss with your doctor the best way to prevent osteoporosis.
SS from Cambridge warns against a toxic plant:
"A plant you don't mention is garden rue (Ruta graveolens); it took some time for us to realise that it was this herb which was causing the painful blisters on my children's legs. The effect is particularly bad on hot days, and you only have to brush past it for it to have an effect."
Please send your 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 to email@example.com. Dr Kavalier is unable to respond personally.